TAVIA MARIE VITAL (NPI# 1508145756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508145756 |
| Entity Type | Individual |
| Full Name | TAVIA MARIE VITAL |
| Credential | RN, CDE |
| Practice Address |
2560 24th St Suite 102 Rock Island IL 61201-5357 |
| Practice Telephone | 3097880014 |
| Practice Fax Number | 3097933092 |
| Mailing Telephone | 3097880014 |
| Mailing Fax Number | 3097933092 |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2011-08-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WD0400X |
Registered Nurse Specialization: Diabetes Educator |
041390337 | IL | Nursing Service Providers |
| Street Address |
2560 24TH ST SUITE 102 |
| City | ROCK ISLAND |
| State | IL |
| Zip Code | 61201-5357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548265556 | Patrick C Cunningham | Family Medicine | 2560 24th St, Ste 202, Rock Island, IL 61201-5390 | 2005-06-16 |
| 1548655798 | Lynnda Jean Garrett | Registered Nurse | 2560 24th St, Ste 101, Rock Island, IL 61201-5357 | 2015-04-04 |
| 1902201791 | Melinda Sue Allison | Nurse Practitioner | 2560 24th St, Suite 201, Rock Island, IL 61201-5357 | 2014-10-23 |
| 1780856187 | M. Hassan Diab, M.d., S.c. | Internal Medicine | 2560 24th St, Suite 201, Rock Island, IL 61201-5357 | 2008-03-26 |
| 1609920636 | Janice E Levsen | Nurse Practitioner | 2560 24th St, Suite 202, Rock Island, IL 61201-5357 | 2007-01-23 |
| 1811003189 | Genesis Health System | Family Medicine | 2560 24th St, Suite 202, Rock Island, IL 61201-5357 | 2006-08-21 |
| 1396719969 | Lakshmi L Alapati | Internal Medicine | 2560 24th St, Suite 201, Rock Island, IL 61201-5357 | 2006-02-13 |
| 1033197140 | Ishwar V Thakkar | Internal Medicine | 2560 24th St, Suite 102, Rock Island, IL 61201-5357 | 2006-01-09 |
| 1255338588 | M Hassan Diab | Internal Medicine | 2560 24th St, Suite 201, Rock Island, IL 61201-5357 | 2005-07-01 |
| 1780680736 | Steven A Ray | Internal Medicine | 2560 24th St, Ste 202, Rock Island, IL 61201-5390 | 2005-06-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689206245 | Judy Kay Moore | Technician | 2439 8th Ave, Rock Island, IL 61201 | 2020-02-11 |
| 1053956862 | Christina Beam | Counselor | 1413 40th Street, Rock Island, IL 61201 | 2019-11-15 |
| 1356843817 | Stephanie Kaye Jones | Counselor | 2701 17th St., Rock Island, IL 61201 | 2018-03-01 |
| 1073062030 | Innovative Transport Enterprise, LLC | Non-emergency Medical Transport (VAN) | 2239 24th Street Apt 15c, Rock Island, IL 61201 | 2016-09-30 |
| 1124575733 | Robert Young Center | Community Based Residential Treatment Facility, Mental Illness | 2701 - 17 Street, Rockisland, IL 61201 | 2016-09-01 |
| 1538520903 | James Keith Frainey | Psychologist | 805 19th Street, Transitions Mhs, Rock Island, IL 61201 | 2016-03-14 |
| 1417340837 | Brandon Lee Sachwitz | Physician Assistant | 2701 17th Street, Trinity Medical Center, Rock Island, IL 61201 | 2015-03-10 |
| 1215366679 | Kimberly Lyall | Physical Therapy Assistant | 767 30th Street, Rock Island, IL 61201 | 2013-11-06 |
| 1386080745 | The Abbey Center, LLC | Clinic/Center | 3031 5th Ave., Rock Island, IL 61201 | 2013-05-13 |
| 1487097382 | Joe Lee Westerhof | Veterinarian | 2529 11th St, Rock Island, IL 61201 | 2013-04-10 |
| Find all providers in zip 61201 | ||||
| Taxonomy Code | 163WD0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Diabetes Educator |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508485954 | Melissa M Ptak | Registered Nurse | 605 W Central Rd Ste 101, Arlington Heights, IL 60005-2389 | 2020-04-15 |
| 1790260552 | Highland Park Cvs, L.L.C. | Registered Nurse | 800 Carlyle Ave, Belleville, IL 62221-5509 | 2018-09-27 |
| 1770035636 | Highland Park Cvs, L.l.c | Registered Nurse | 10405 N Centerway Dr, Peoria, IL 61615-1233 | 2016-10-26 |
| 1114384583 | Debra Newbolds | Registered Nurse | 117 Weisbrook Ln, Carterville, IL 62918-2320 | 2016-01-15 |
| 1093022360 | Andrea Gebhart | Registered Nurse | 3722 S. Harlem Ave., Suite 202, Riverside, IL 60546 | 2010-09-08 |
| 1013148295 | Clara May Miller | Registered Nurse | 1025 Bonnie Brae Pl, River Forest, IL 60305-1513 | 2009-08-05 |
| 1801007422 | Elyssa Joy Springer | Registered Nurse | 251 E Huron, Northwestern Memorial Hospital # 4-508, Chicago, IL 60611 | 2007-05-25 |
| 1245390285 | Highland Park Cvs, L.L.C. | Registered Nurse | 2642 Charles St, Rockford, IL 61108-1671 | 2006-12-11 |
| 1548296890 | Highland Park Cvs, L.L.C. | Registered Nurse | 1129 W Broadway, Centralia, IL 62801-5353 | 2006-06-25 |
| 1376579623 | Highland Park Cvs, L.L.C. | Registered Nurse | 109 N Mattis Ave, Champaign, IL 61821-3059 | 2006-06-25 |
| Find all providers with the same taxonomy | ||||
| City | ROCK ISLAND |
| Zip Code | 61201 |
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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.