GREGORY E BRANDT (NPI# 1356326821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356326821 |
| Entity Type | Individual |
| Full Name | GREGORY E BRANDT |
| Credential | M.D. |
| Practice Address |
301 N 8th St Springfield IL 62701-1041 |
| Mailing Address |
Po Box 19639 Springfield IL 62794-9639 |
| Practice Telephone | 2175455817 |
| Practice Fax Number | 2175454117 |
| Mailing Telephone | 2175457578 |
| Mailing Fax Number | 2175451884 |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2020-10-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
036-091442 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036091442 | 05 |
| Street Address |
301 N 8TH ST |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62701-1041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578565420 | Samuel Poriza Au | Radiology | 301 N 8th St, Springfield, IL 62701-1041 | 2005-08-11 |
| 1073148375 | Ashley Kirkpatrick | Nurse Practitioner | 301 N 8th St, Springfield, IL 62701-1041 | 2020-03-06 |
| 1699260299 | Eman Mosleh | Pediatrics | 301 N 8th St, Springfield, IL 62701-1041 | 2018-06-26 |
| 1508370719 | Linsey Meloche | Nurse Practitioner | 301 N 8th St, Springfield, IL 62701-1041 | 2017-11-27 |
| 1649789736 | Nichole Kristine Chatham | Occupational Therapist | 301 N 8th St, Springfield, IL 62701-1041 | 2017-09-21 |
| 1174075147 | Loralee Donnelly | Nurse Practitioner | 301 N 8th St, Springfield, IL 62701 | 2016-10-26 |
| 1740639533 | Matthew Leland Davis | Urology | 301 N 8th St, Springfield, IL 62701-1041 | 2016-06-13 |
| 1578910741 | Bradley Christopher Holland | Urology | 301 N 8th St, 4b143c, Springfield, IL 62701-1041 | 2016-05-18 |
| 1295182467 | Meredith Volle | Pediatrics | 301 N 8th St, 4a, Springfield, IL 62701-1041 | 2016-05-18 |
| 1205299542 | Rebecca S. Vanmeter | Nurse Practitioner | 301 N 8th St, Springfield, IL 62701-1041 | 2016-04-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932687183 | Affinity Patient Coordination LLC | In Home Supportive Care | 217 E Monroe St Ste 102, Springfield, IL 62701 | 2018-07-31 |
| 1427498435 | Donald L Jacoby | Pharmacist | 701 N. First St., Springfield, IL 62701 | 2013-07-05 |
| 1700183480 | Erin Zepp | Dietitian, Registered | 319 E Madison St Ste 1f, Springfield, IL 62701 | 2011-02-16 |
| 1518117159 | Jyoti Assudani | Pediatrics | 301 N 8th Street, Springfield, IL 62701 | 2008-09-19 |
| 1396924148 | Jeanne Lyn Malone | Counselor | 408 South Fifth Street, Springfield, IL 62701 | 2007-10-29 |
| 1942422928 | Nobuharu Harada | Family Medicine | 301 N 8th, Pav-3a158, Springfield, IL 62701 | 2007-05-02 |
| 1427131127 | Radiological Associates of Decatur | Radiology | 319 E Madison Suite J, Springfield Mri & Imaging Center, Springfield, IL 62701 | 2006-10-24 |
| 1669498606 | Independence Holding Co LLC | Pharmacy | 201 North 5th Street, Springfield, IL 62701 | 2006-07-14 |
| 1720070238 | Neil J. Thomas | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 619 E Mason St Ste 4p57, Springfield, IL 62701 | 2005-08-19 |
| 1588187397 | Andrea Nicole Bloodworth | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701 | 2017-07-24 |
| Find all providers in zip 62701 | ||||
| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639395304 | Lenore Evans Gonzalez | Pediatrics | 236 S 5th St, Apt C, Springfield, IL 62701-1431 | 2007-04-18 |
| 1578851648 | Kenneth E Bujold IIi | Pediatrics | 759 Chestnut Street, Springfield, MA 01107-1619 | 2011-07-11 |
| 1326121518 | Matthew W Richardson | Pediatrics | 759 Chestnut Street, 2nd Floor, Springfield, MA 01107-1619 | 2006-10-23 |
| 1285727727 | Francisca Remilekun Fasipe | Pediatrics | 1235 E Cherokee St, St Jude - Mercy Affiliate Clinic, Springfield, MO 65804-2203 | 2006-10-02 |
| 1144284241 | Joanna Luty | Pediatrics | 759 Chestnut Street, Sw3500, Springfield, MA 01107-1619 | 2006-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265720510 | Reuben Antony | Pediatrics | 530 Ne Glen Oak Ave., C/o Ms Suzy Lewellen, Peoria, IL 61637 | 2011-07-20 |
| 1780829911 | Richard Moldwin | Pediatrics | 9017 Ewing Ave, Evanston, IL 60203-1908 | 2008-12-02 |
| 1801005848 | Marie-ellen Tubal Sarvida | Pediatrics | 4440 West 95th Street, Oak Lawn, IL 60453 | 2007-05-22 |
| 1700948643 | Astrid K. Mack | Pediatrics | 2300 N Childrens Plz # 30, Chicago, IL 60614-3363 | 2006-12-15 |
| 1659449163 | Pediatric Cancer Institute | Pediatrics | 4440 W.95th Street, Oak Lawn, IL 60453 | 2006-12-01 |
| 1699724385 | Joanna Lynn Weinstein | Pediatrics | 2300 Childrens Plaza Box 30, Childrens Memorial Hospital Hem Onc, Chicago, IL 60614 | 2006-05-09 |
| 1568433050 | University of Illinois | Pediatrics | St Jude Midwest Affiliate, 530 Ne Glen Oak, Peoria, IL 61637-0001 | 2006-02-01 |
| 1396731063 | Michael D Tarantino | Pediatrics | 9128 N Lindbergh Dr, Peoria, IL 61615-1422 | 2005-09-27 |
| 1427051622 | John M Cunningham | Pediatrics | 5841 South Maryland Ave, University of Chicago Rm N-112 Mc 4060, Chicago, IL 60637 | 2005-05-23 |
| 1841293032 | Pedro A De Alarcon | Pediatrics | Children's Hospital of Illinois 530 Ne Glen Oak Ave, Peoria, IL 61637 | 2005-05-23 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGFIELD |
| Zip Code | 62701 |
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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.