MS. CATHY DIANE LISENBY (NPI# 1346356524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346356524 |
| Entity Type | Individual |
| Full Name | MS. CATHY DIANE LISENBY |
| Credential | PA-C |
| Practice Address |
2 Good Samaritan Way Mount Vernon IL 62864-2408 |
| Mailing Address |
5100 Lake Ter Ne Ste Wc Mount Vernon IL 62864-9665 |
| Practice Telephone | 6188994000 |
| Practice Fax Number | 6188994790 |
| Mailing Telephone | 6188995001 |
| Mailing Fax Number | 6182425152 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2018-01-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0850001397 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2 GOOD SAMARITAN WAY |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-2408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093718900 | Ssm Health Businesses | Hospice Care, Community Based | 2 Good Samaritan Way, Suite 325, Mount Vernon, IL 62864-2408 | 2005-05-24 |
| 1417573734 | Scherrie Lynn Medina | Registered Nurse | 2 Good Samaritan Way, Mount Vernon, IL 62864-2408 | 2020-06-23 |
| 1245711779 | Mary K Mcgarvey | Occupational Therapy Assistant | 2 Good Samaritan Way, Mount Vernon, IL 62864-2408 | 2018-08-23 |
| 1831611334 | Patricia Isabel Calcetto | Nurse Anesthetist, Certified Registered | 2 Good Samaritan Way, Mount Vernon, IL 62864-2408 | 2017-07-17 |
| 1821548207 | Nicole Vetter | Nurse Practitioner | 2 Good Samaritan Way, Medical Plaza Suite 420, Mount Vernon, IL 62864-2408 | 2016-10-10 |
| 1740654821 | Kathryn Flanigan | Speech-Language Pathologist | 2 Good Samaritan Way, 3rd Floor, Mount Vernon, IL 62864-2408 | 2015-11-30 |
| 1275900656 | Christopher Bourget | Registered Nurse | 2 Good Samaritan Way, Medical Plaza Suite 205, Mount Vernon, IL 62864-2408 | 2015-09-01 |
| 1992188338 | Carl Robert Davis | Nurse Anesthetist, Certified Registered | 2 Good Samaritan Way, Suite 205, Mount Vernon, IL 62864-2408 | 2015-07-02 |
| 1871919845 | Michell R Ellis | Pharmacist | 2 Good Samaritan Way, Suite 120, Mount Vernon, IL 62864-2408 | 2014-03-13 |
| 1548685647 | Rebecca Breanne Ritchey | Speech-Language Pathologist | 2 Good Samaritan Way, Mount Vernon, IL 62864-2408 | 2014-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982249124 | Leticia B Barrientos | Physician Assistant | 472 Gramatan Ave Apt Bb4, Mount Vernon, NY 10552-2979 | 2019-11-12 |
| 1396390522 | Elizabeth Kuriakose | Physician Assistant | 203 Gramatan Ave Ste A, Mount Vernon, NY 10550-1291 | 2019-08-05 |
| 1174941728 | Lyndsey Switzer | Physician Assistant | 1600 Continental Pl Ste 101, Mount Vernon, WA 98273-5607 | 2014-04-01 |
| 1255585311 | Pamela Welch | Physician Assistant | 5754 Farm Road 21, Mount Vernon, TX 75457-7749 | 2008-11-15 |
| 1881857787 | Telesforo Llamas Jr. | Physician Assistant | 2 Fisher Dr, Apartment 607, Mount Vernon, NY 10552-3666 | 2008-07-10 |
| 1275712614 | Naima R Abdus-salaam | Physician Assistant | 495 N Fulton Ave, Mount Vernon, NY 10552-1909 | 2007-11-02 |
| 1316006588 | Lee Barry Leavelle | Physician Assistant | 107 W 4th Street, Mount Vernon Neighborhood Health Ctr, Mount Vernon, NY 10550 | 2006-12-06 |
| 1215096359 | Patricia Taddeo | Physician Assistant | 107 West Fourth St, Mount Vernon Neighborhood Health Center, Mount Vernon, NY 10550 | 2006-12-06 |
| 1831270065 | Rochelle A, Trussell | Physician Assistant | 1400 E. Kincaid St, Mount Vernon, WA 98274-4127 | 2006-10-17 |
| 1750497061 | Shirley Dallmier | Physician Assistant | 3307 Broadway St Ste 130, Physician Rural Health Clinic of Jefferson County, Mount Vernon, IL 62864-2387 | 2006-08-21 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.