PRAIRIE BLEEDING AND CLOTTING CENTER (NPI# 1518313287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518313287 |
| Entity Type | Organization |
| Organization Name | PRAIRIE BLEEDING AND CLOTTING CENTER |
| Practice Address |
105 S Amos Ave Springfield IL 62704-1528 |
| Practice Telephone | 2175467100 |
| Practice Fax Number | 2175467111 |
| Mailing Telephone | 2175467100 |
| Mailing Fax Number | 2175467111 |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2016-05-11 |
| Authorized Official Name | DR. OSVALDO H WESLY (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2175467100 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 036.089289 | IL | Other Service Providers |
| Street Address |
105 S AMOS AVE |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62704-1528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669015566 | Hollie Hangartner | Nurse Practitioner | 105 S Amos Ave, Springfield, IL 62704-1528 | 2019-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902394901 | Hillary Haaker | Occupational Therapist | 2035 W Iles, Suite C, Springfield, ID 62704 | 2018-04-25 |
| 1871095364 | Edward Doyle Slifer Sr. | Pathology | 2117 Greenside Drive, Spring Field, IL 62704 | 2018-03-01 |
| 1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
| 1447774757 | Lisa Ann Rogers | Developmental Therapist | 2101 Lexington Dr, Apt 3, Springfield, IL 62704 | 2017-07-28 |
| 1730611286 | Mindi Rowe | Occupational Therapist | 2508 County Rd 4 1/2 E, Springfield, IL 62704 | 2017-04-03 |
| 1366992208 | Jayme Jordan | Contractor | 2409 Westchester Blvd, Springfield, IL 62704 | 2016-10-04 |
| 1154793974 | Dina Payne | Social Worker | 917 Clocktower Drive, Suite 600, Springfield, IL 62704 | 2015-10-21 |
| 1770959819 | James R Reynolds | Hearing Instrument Specialist | 2347 W Monroe St, Springfield, IL 62704 | 2015-08-12 |
| 1336576495 | Emily Jane Dungey | Counselor | 920 S Spring St Ste 1300, Springfield, IL 62704 | 2013-10-03 |
| 1942552161 | Jeannie Marie Hundley | Specialist/Technologist, Other | 2921 Monvale Drive, Springfield, IL 62704 | 2012-10-11 |
| Find all providers in zip 62704 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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| 1811354681 | Monica M Jones | Specialist | 118 Victory Rd Apt 315, Springfield, NJ 07081-1342 | 2016-01-25 |
| 1215334941 | Brandon Avenue Pediatrics | Specialist | 6126 Brandon Ave, Springfield, VA 22150-2610 | 2014-11-24 |
| 1558766006 | Ozark Retina & Macula | Specialist | 1230 E Kingsley St Ste A, Springfield, MO 65804-7231 | 2014-10-27 |
| 1396146411 | Colin Bailey | Specialist | 155 S Tuttle Rd, Springfield, OH 45505-1560 | 2014-09-08 |
| 1659771350 | Ronnie L. Jackson Md | Specialist | 496 Northcrest Dr, Springfield, TN 37172-3972 | 2014-08-29 |
| 1659781136 | Ashley Foucha | Specialist | 1342 E Primrose St Ste A, Springfield, MO 65804-4224 | 2014-05-05 |
| 1225452881 | Elizabeth Creps | Specialist | 1623 21st St Ste B, Springfield, OR 97477-3417 | 2014-02-18 |
| 1649691098 | Kristin Seybold | Specialist | 1333 N 1st St, Springfield, OR 97477-3002 | 2014-01-01 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62704 |
Please comment or provide details below to improve the information on PRAIRIE BLEEDING AND CLOTTING CENTER.
| 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.