PC ASSOCIATES, LLC (NPI# 1386958668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386958668 |
| Entity Type | Organization |
| Organization Name | PC ASSOCIATES, LLC |
| Practice Address |
4550 Memorial Dr Ste 180 Belleville IL 62226-5372 |
| Mailing Address |
4500 Memorial Dr Medical Affairs Credentialing Department Belleville IL 62226-5360 |
| Practice Telephone | 6182358282 |
| Practice Fax Number | 6182358799 |
| Mailing Telephone | 6182574644 |
| Mailing Fax Number | 6182576946 |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2013-02-15 |
| Authorized Official Name | LISA K MCDONALD (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 6182574644 |
| Is Organization Subpart | Y |
| Parent Organization Name | PC ASSOCIATES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548786460 | Pc Associates, LLC | Family Medicine | 200 Admiral Trost Rd Ste 1a, Columbia, IL 62236-2163 | 2017-08-22 |
| 1205361110 | Pc Associates, LLC | Family Medicine | 1095 Beltline Road, Suite 500, Collinsville, IL 62234 | 2017-04-28 |
| 1881135622 | Pc Associates, LLC | Family Medicine | 800 East Highway 50, O'fallon, IL 62269 | 2017-03-13 |
| 1386950012 | Pc Associates, LLC | Family Medicine | 1245 S Mill St # 231, Nashville, IL 62263-2004 | 2010-08-18 |
| 1619280112 | Pc Associates, LLC | Family Medicine | 4017 Illinios Rt. 159, Ste 101, Smithton, IL 62285 | 2010-07-26 |
| 1417260613 | Pc Associates, LLC | Family Medicine | 830 Admiral Weinel Blvd, Columbia, IL 62236-1992 | 2010-07-16 |
| 1982917183 | Pc Associates, LLC | Family Medicine | 501 Beltline Road, Ste 20-d, Collinsville, IL 62234-4410 | 2010-07-16 |
| 1184717019 | Pc Associates, LLC | Family Medicine | 310 N. Seven Hills Road, O'fallon, IL 62269 | 2006-10-02 |
| 1881117125 | Pc Associates, LLC | Internal Medicine | 1414 Cross St Ste 230, Shiloh, IL 62269-2988 | 2017-07-19 |
| 1629443601 | Pc Associates, LLC | Family Medicine | 3 Park Pl, Swansea, IL 62226-2965 | 2015-12-02 |
| Street Address |
4550 MEMORIAL DR STE 180 |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226-5372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427055961 | Lawrence Mcclinton | Physician Assistant | 4550 Memorial Dr, Ste. 280, Belleville, IL 62226-5372 | 2005-06-30 |
| 1902273717 | Tammi Lynn Jones | Nurse Practitioner | 4550 Memorial Dr, Suite 360, Belleville, IL 62226-5372 | 2015-08-27 |
| 1235474057 | Memorial Medical Group, LLC | Anesthesiology | 4550 Memorial Dr, Ste. 340, Belleville, IL 62226-5372 | 2012-12-05 |
| 1013265248 | Deanna L. Rodenberg | Registered Nurse | 4550 Memorial Dr, Ste. 340, Belleville, IL 62226-5372 | 2012-08-20 |
| 1699061259 | Oa Associated LLC | Specialist/Technologist | 4550 Memorial Dr, Moc-1, Suite G-100, Belleville, IL 62226-5372 | 2011-06-22 |
| 1619260932 | Dori Hunt | Nurse Practitioner | 4550 Memorial Dr, Ste. 340, Belleville, IL 62226-5372 | 2011-05-19 |
| 1821302118 | Pc Associates, LLC | Hospitalist | 4550 Memorial Dr, Suite 340, Belleville, IL 62226-5372 | 2010-07-29 |
| 1376857656 | Ca Group, LLC | Internal Medicine | 4550 Memorial Dr, Ste 310, Belleville, IL 62226-5372 | 2010-07-29 |
| 1649584921 | Ca Group LLC | Internal Medicine | 4550 Memorial Dr, Suite 320, Belleville, IL 62226-5372 | 2010-07-29 |
| 1295049666 | Msa Alliance, LLC | Urology | 4550 Memorial Dr, Ste 350, Belleville, IL 62226-5372 | 2010-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417591173 | Dimi Dawn Resch | Family Medicine | 373 Roanoke Dr, Belleville, IL 62221-5723 | 2019-11-05 |
| 1013559749 | Christine Evansco | Family Medicine | 105 S 35th St, Belleville, IL 62226-6314 | 2019-10-15 |
| 1851800288 | Republic County Family Clinic, P.a. | Family Medicine | 2337 G St Ste 2, Belleville, KS 66935-2462 | 2017-09-28 |
| 1154854008 | Kurtis William Klecan | Family Medicine | 2337 G St Ste 100, Belleville, KS 66935-2462 | 2017-04-07 |
| 1144753096 | Ace Medical Services LLC | Family Medicine | 929 Ridgecrest Dr, Belleville, IL 62220-3163 | 2017-04-07 |
| 1558743138 | Patrick Nakashima-moran | Family Medicine | 2900 Frank Scott Pkwy W Ste 904, Belleville, IL 62223 | 2015-06-19 |
| 1871993139 | Wayne Bresee Cox II | Family Medicine | 10 Celeste Ct, Belleville, IL 62223-1907 | 2014-08-23 |
| 1811252547 | Jianming Alexander Lau | Family Medicine | 201 3rd St 200, Belleville, MI 48111-2605 | 2012-07-09 |
| 1548531320 | Donald H Buser | Family Medicine | 116 S Fairway Dr, Belleville, IL 62223-2228 | 2012-01-25 |
| 1275824096 | Pc Associates LLC | Family Medicine | 2129 W. Main St., Belleville, IL 62223 | 2011-04-27 |
| Find all providers in BELLEVILLE | ||||
| City | BELLEVILLE |
| Zip Code | 62226 |
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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.