SPRINGFIELD CLINIC PHYSICAL THERAPY (NPI# 1417120635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417120635 |
| Entity Type | Organization |
| Organization Name | SPRINGFIELD CLINIC PHYSICAL THERAPY |
| Practice Address |
800 N 1st St Springfield IL 62702-3719 |
| Mailing Address |
1025 S 6th St Springfield IL 62703-2416 |
| Practice Telephone | 2175287541 |
| Mailing Telephone | 2175287541 |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2017-07-24 |
| Authorized Official Name | MR. ALAN NERONE (SENIOR VICE PRESIDENT & CFO) |
| Authorized Official Telephone | 2175287541 |
| Is Organization Subpart | Y |
| Parent Organization Name | SPRINGFIELD CLINIC LLP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Street Address |
800 N 1ST ST |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-3719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154321222 | Piero Capecci | Orthopaedic Surgery | 800 N 1st St, Springfield, IL 62702-3719 | 2005-07-29 |
| 1811504087 | Dylan S Mckinney | Nurse Practitioner | 800 N 1st St, Springfield, IL 62702-3719 | 2020-09-30 |
| 1407460512 | Sarah L Nunez | Physical Therapist | 800 N 1st St, Springfield, IL 62702-3778 | 2020-09-04 |
| 1720601784 | Dorothy V Pham | Physician Assistant | 800 N 1st St, Springfield, IL 62702-3719 | 2020-05-26 |
| 1922644137 | Gregory L Young | Specialist/Technologist, Other | 800 N 1st St, Springfield, IL 62702-3719 | 2019-11-22 |
| 1912550468 | Mary R. Mullins | Nurse Practitioner | 800 N 1st St, Springfield, IL 62702-3719 | 2019-07-23 |
| 1588224927 | Ashley M. Boyle | Physical Therapist | 800 N 1st St, Springfield, IL 62702-3719 | 2019-06-18 |
| 1013572114 | Kendra Miller | Physical Therapy Assistant | 800 N 1st St, Springfield, IL 62702-3778 | 2019-05-03 |
| 1801451067 | Anna Neumann | Occupational Therapy Assistant | 800 N 1st St, Springfield, IL 62702-3719 | 2019-05-03 |
| 1316408776 | Jennifer A. Drennan | Physical Therapist | 800 N 1st St, Springfield, IL 62702-3719 | 2019-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184221335 | Convergence Physical Therapy and Performance | Clinic/Center | 303 S 5th St Ste 140, Springfield, OR 97477-5480 | 2020-10-01 |
| 1275146474 | Beyond Recovery Physical Therapy, LLC | Clinic/Center | 2627 E Horning St, Springfield, MO 65802-2372 | 2020-08-26 |
| 1538786272 | Neurologic Optimal Wellness Physical Therapy LLC | Clinic/Center | 180 King St, Springfield, MA 01109-4316 | 2020-06-29 |
| 1154948933 | My Pt and Pilates Inc | Clinic/Center | 6706 Red Jacket Rd, Springfield, VA 22152-2633 | 2020-06-29 |
| 1043836588 | Martin Ventures LLC | Clinic/Center | 3119 S Scenic Ave Ste B, Springfield, MO 65807-3965 | 2020-06-21 |
| 1871129338 | Five Star Rehabilitation and Wellness Services LLC | Clinic/Center | 900 E Southwind Rd, Springfield, IL 62703-5369 | 2020-03-17 |
| 1992262554 | Agilitas Usa, Inc | Clinic/Center | 3556 Tom Austin Hwy Ste 2, Springfield, TN 37172-3960 | 2019-03-01 |
| 1336656461 | Back and Body Pain Relief LLC | Clinic/Center | 355 Route 22 Ste D, Springfield, NJ 07081-3511 | 2018-01-10 |
| 1699142828 | Alissa Slater | Clinic/Center | 7912 Journey Ln, Springfield, VA 22153-2725 | 2015-08-24 |
| 1801189121 | Physiotherapy Associates Inc | Clinic/Center | 1739 Allen St, Springfield, MA 01118-1805 | 2011-05-19 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
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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.