PARKCREST ORTHOPEDICS LLC (NPI# 1346509403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346509403 |
| Entity Type | Organization |
| Organization Name | PARKCREST ORTHOPEDICS LLC |
| Practice Address |
509 Hamacher St Ste 202 Waterloo IL 62298-1592 |
| Mailing Address |
845 N New Ballas Ct Ste 130 Saint Louis MO 63141-7134 |
| Practice Telephone | 3149971777 |
| Practice Fax Number | 3149976277 |
| Mailing Telephone | 3149971777 |
| Mailing Fax Number | 3149976277 |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2012-05-10 |
| Authorized Official Name | MRS. KIM UZZETTA (PRACTICE MANAGER) |
| Authorized Official Telephone | 3149971777 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 036118660 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | GROUP MEMBER NPI | 1518968759 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568860641 | Parkcrest Orthopedics LLC | Orthopaedic Surgery | 508 W Pine St, Farmington, MO 63640-1426 | 2014-12-05 |
| 1225210222 | Parkcrest Orthopedics LLC | Orthopaedic Surgery | 965 Mattox Dr, Sullivan, MO 63080-2365 | 2007-11-30 |
| Street Address |
509 HAMACHER ST STE 202 |
| City | WATERLOO |
| State | IL |
| Zip Code | 62298-1592 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932101532 | Kenneth D Hawn | Pediatrics | 509 Hamacher St, Suite 103, Waterloo, IL 62298-1592 | 2005-08-12 |
| 1053846816 | Brittney Voyda | Nurse Practitioner | 509 Hamacher St, St # 102, Waterloo, IL 62298-1592 | 2017-04-28 |
| 1851830236 | Samantha Lynn Boman | Physical Therapist | 509 Hamacher St, Suite101, Waterloo, IL 62298-1592 | 2017-02-17 |
| 1346784675 | Associated Physicians Group Ltd | Physician Assistant | 509 Hamacher St, Suite 202, Waterloo, IL 62298-1592 | 2016-12-06 |
| 1912373903 | Aaron P Henry | Physical Therapist | 509 Hamacher St, Ste 101, Waterloo, IL 62298-1592 | 2015-08-13 |
| 1992191951 | Red Bud Regional Clinic Company LLC | Family Medicine | 509 Hamacher St, Suite 103, Waterloo, IL 62298-1592 | 2015-04-07 |
| 1821489477 | Linda Peck | Specialist/Technologist | 509 Hamacher St, Waterloo, IL 62298-1592 | 2015-02-17 |
| 1568853018 | St Anthony's Physician Organization of Illinois | Obstetrics & Gynecology | 509 Hamacher St, Ste 203, Waterloo, IL 62298-1592 | 2015-02-05 |
| 1053700229 | Kerri Dockins-hall | Physical Therapist | 509 Hamacher St, Ste 101, Waterloo, IL 62298-1592 | 2015-01-12 |
| 1508286477 | Cari Stefani | Nurse Practitioner | 509 Hamacher St, Suite 103, Waterloo, IL 62298-1592 | 2014-04-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508471418 | Waterloo Urgent Care Walk In Clinic Company | Clinic/Center | 901 Illinois Route 3, Waterloo, IL 62298 | 2020-09-09 |
| 1235624867 | Las Davis Enterprises | Hearing Instrument Specialist | 911 State Rte 3, Waterloo, IL 62298 | 2018-06-26 |
| 1255727269 | Anna Witges | Counselor | 988 Il-3, Waterloo, IL 62298 | 2015-04-07 |
| 1558766741 | Sheri Buettner | Counselor | 988 Illinois Route 3, Waterloo, IL 62298 | 2014-10-30 |
| 1386050953 | Jessica Liefer | Counselor | 988 N Illinois Rt 3, Waterloo, IL 62298 | 2014-07-03 |
| 1952729279 | Orthodontic Associates of Columbia and Waterloo | Dentist | 224 Bradford Lane Suite B, Waterloo, IL 62298 | 2014-04-03 |
| 1588963961 | Monroe County Surgical Center,llc | Clinic/Center | 501 Hamacher St, Waterloo, IL 62298 | 2011-03-24 |
| 1841523776 | Waterloo Women's Health | Nurse Practitioner | 869 N. Illinois Rt 3, Waterloo, IL 62298 | 2009-09-10 |
| 1548444011 | Marla Rae Smith | Nurse Practitioner | 869 North Illinois Rt 3, Waterloo, IL 62298 | 2007-12-20 |
| 1649464553 | Clarkson Optometry Illinois PC | Optometrist | 204 Bradford Lane, Waterloo, IL 62298 | 2007-09-04 |
| Find all providers in zip 62298 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174559447 | Arnold Eugene Delbridge | Orthopaedic Surgery | 164 West Dale St, Waterloo, IA 50703-1925 | 2006-06-25 |
| 1861448128 | Christopher L Eagan | Orthopaedic Surgery | 2750 Saint Francis Dr, Ste 319, Waterloo, IA 50702-5644 | 2006-05-26 |
| 1417900705 | Jay Paul Ginther | Orthopaedic Surgery | 4006 Johnathan St, Suite B, Waterloo, IA 50701-9395 | 2006-05-18 |
| 1356789390 | Mark Gorsche | Orthopaedic Surgery | 1631 Logan Ave, Waterloo, IA 50703 | 2013-06-12 |
| 1851411532 | Robert Boyd Bartelt | Orthopaedic Surgery | 1631 Logan Ave, Waterloo, IA 50703 | 2007-03-29 |
| 1700813441 | Gary A Knudson | Orthopaedic Surgery | 2710 Saint Francis Dr, Suite 319, Waterloo, IA 50702-5619 | 2006-06-27 |
| 1750317756 | Richard W. Naylor | Orthopaedic Surgery | 2710 Saint Francis Dr, Suite 319, Waterloo, IA 50702-5619 | 2006-06-23 |
| 1821042516 | Jim Eldon Crouse | Orthopaedic Surgery | 1753 W Ridgeway Ave, Ste 103 B, Waterloo, IA 50701-4521 | 2006-05-19 |
| 1568416196 | Thomas Stewart Gorsche | Orthopaedic Surgery | 1631 Logan Ave, Waterloo, IA 50703 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144834680 | Illinois Bone and Joint Institute LLC | Orthopaedic Surgery | 1200 S York St Ste 4110, Elmhurst, IL 60126-5630 | 2020-09-02 |
| 1790303725 | Illinois Bone and Joint Institute LLC | Orthopaedic Surgery | 1009 Il Route 22 Ste 2, Fox River Grove, IL 60021-1998 | 2020-07-07 |
| 1104440049 | Elliot M Johns | Orthopaedic Surgery | 301 N 8th St Ste 3a158, Springfield, IL 62701-1085 | 2020-06-06 |
| 1740804764 | David Alan Forgas | Orthopaedic Surgery | 901 N 1st St # D252, Springfield, IL 62702-3759 | 2020-06-05 |
| 1700417185 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 1890 Silver Cross Blvd # A, New Lenox, IL 60451-9524 | 2020-02-04 |
| 1588207799 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 2719 W Algonquin Rd, Algonquin, IL 60102-9400 | 2019-10-21 |
| 1669020848 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 406 Front St Ste 100, Mchenry, IL 60050-5593 | 2019-08-30 |
| 1790342194 | Kevin James Rasuli | Orthopaedic Surgery | 1611 W Harrison St. Ste. 400, Chicago, IL 60612 | 2019-05-22 |
| 1134680713 | Madeline Shaoyun Tiee | Orthopaedic Surgery | Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153 | 2019-03-27 |
| 1538629746 | Michael Murphy | Orthopaedic Surgery | 2160 S 1st Ave., Maguire Center, Dept of Ortho Surg, Maywood, IL 60153 | 2019-03-22 |
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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.