ANTHONY RAY AGATUCCI (NPI# 1457534810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457534810 |
| Entity Type | Individual |
| Full Name | ANTHONY RAY AGATUCCI |
| Credential | M.D. |
| Practice Address |
4809 Blackwolf Rd Springfield IL 62711-7856 |
| Practice Telephone | 2177876533 |
| Mailing Telephone | 2177876533 |
| Enumeration Date | 2007-12-08 |
| Last Update Date | 2007-12-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | IL | Allopathic & Osteopathic Physicians |
| Street Address |
4809 BLACKWOLF RD |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62711-7856 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578057220 | Merissa Pryor | Social Worker | 4200 Conestoga Drive, Mbn 120, Springfield, IL 62711 | 2018-06-17 |
| 1255884623 | Dental Professionals of Illinois, P.C. | Dentist | 2740 Prairie Crossing Drive, Springfield, IL 62711 | 2016-08-02 |
| 1841682424 | Americare At Centennial Pointe Assisted Living LLC | Assisted Living Facility | 3440 Hedley Road, Springfield, IL 62711 | 2015-02-19 |
| 1306249248 | Schon Dental, LLC | Dentist | 2809 Mansion Road Suite D, Springfield, IL 62711 | 2014-10-07 |
| 1891105490 | John Weiss | Pharmacist | 4200 Conestoga Drive, Springfield, IL 62711 | 2014-05-05 |
| 1720350689 | Victor Harold Lary | Family Medicine | 3251 Spaulding Orchard Road, Springfield, IL 62711 | 2012-02-07 |
| 1902181795 | Amanda Rose Davis | Pharmacist | 2500 Koke Mill Rd, Springfield, IL 62711 | 2011-10-12 |
| 1316233703 | Karen Zerkle | Dentist | 2809 Mansion Rd, Suite D, Springfield, IL 62711 | 2011-06-23 |
| 1255520557 | Link Chiropractic LLC | Chiropractor | 7012 Kingsmill Ct, Springfield, IL 62711 | 2007-10-23 |
| 1669688230 | Victoria Lynn Driskill | Dentist | 4701 W. Wabash Ave, Springfield, IL 62711 | 2007-05-14 |
| Find all providers in zip 62711 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467074492 | Kinnera Are | Pediatrics | 400 N 9th St Ste 4a, Springfield, IL 62702-5310 | 2020-05-13 |
| 1306208368 | Mckenzie Smith | Pediatrics | 2115 S Fremont Ave Ste 2900, Springfield, MO 65804-2233 | 2016-03-28 |
| 1790181402 | Sonam Verma | Pediatrics | 400 N 9th St # 4a, Springfield, IL 62702-5310 | 2014-11-06 |
| 1619382132 | Eric D Mcfeely | Pediatrics | 280 Chestnut Street, 2nd Floor, Springfield, MA 01199-1001 | 2014-06-23 |
| 1073923231 | Charlotte Mcknight | Pediatrics | 6120 Brandon Ave Ste 308, Springfield, VA 22150-2504 | 2014-04-28 |
| 1336437078 | Rashmi Jain | Pediatrics | 1965 S Fremont Ave Ste 260, Springfield, MO 65804-2257 | 2011-07-15 |
| 1861785958 | Sienna Vorono Winer | Pediatrics | 6501 Loisdale Ct., Springfield, VA 22150 | 2011-05-23 |
| 1649581570 | Kendra Suzanne Woods | Pediatrics | 415 N 9th St Ste 2w126, Springfield, IL 62702-5303 | 2010-06-25 |
| 1518117159 | Jyoti Assudani | Pediatrics | 301 N 8th Street, Springfield, IL 62701 | 2008-09-19 |
| 1417105024 | Stephen Edward Saunders | Pediatrics | 5 Orchard Ln, Springfield, IL 62712-8911 | 2008-09-08 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62711 |
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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.