EDWARD TEAMAN JR. (NPI# 1578647970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578647970 |
| Entity Type | Individual |
| Full Name | EDWARD TEAMAN JR. |
| Credential | P.A. |
| Practice Address |
619 E Mason St Suite 4p57 Springfield IL 62701-1034 |
| Mailing Address |
619 E Mason St Ste 4p57 Springfield IL 62701-1034 |
| Practice Telephone | 2177880706 |
| Practice Fax Number | 2175252535 |
| Mailing Telephone | 2177880706 |
| Mailing Fax Number | 2175252535 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2019-05-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
085.002019 | IL | Allopathic & Osteopathic Physicians |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085-002019 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
619 E MASON ST SUITE 4P57 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62701-1034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033190814 | Carl E Arentzen | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 619 E Mason St, Suite 3p25, Springfield, IL 62701-1034 | 2005-11-09 |
| 1669913349 | Laura Grubb | Internal Medicine | 619 E Mason St, Ste. 4p57, Springfield, IL 62701-1034 | 2017-03-15 |
| 1265974604 | Julie Borjon | Internal Medicine | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2016-11-16 |
| 1912358565 | Meleah Vaughan | Nurse Practitioner | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2016-06-24 |
| 1508225616 | Margaret Jordan | Internal Medicine | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2016-02-17 |
| 1487011144 | Shauna Vogler | Internal Medicine | 619 E Mason St, Springfield, IL 62701-1034 | 2016-01-25 |
| 1871987750 | Amy Durako | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2015-03-27 |
| 1215333604 | Meredith Fleming | Internal Medicine | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2014-11-12 |
| 1154623585 | Margie Douglas | Nurse Practitioner | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2010-11-17 |
| 1326378175 | Angela K. Lafrenz | Internal Medicine | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2009-12-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932687183 | Affinity Patient Coordination LLC | In Home Supportive Care | 217 E Monroe St Ste 102, Springfield, IL 62701 | 2018-07-31 |
| 1427498435 | Donald L Jacoby | Pharmacist | 701 N. First St., Springfield, IL 62701 | 2013-07-05 |
| 1700183480 | Erin Zepp | Dietitian, Registered | 319 E Madison St Ste 1f, Springfield, IL 62701 | 2011-02-16 |
| 1518117159 | Jyoti Assudani | Pediatrics | 301 N 8th Street, Springfield, IL 62701 | 2008-09-19 |
| 1396924148 | Jeanne Lyn Malone | Counselor | 408 South Fifth Street, Springfield, IL 62701 | 2007-10-29 |
| 1942422928 | Nobuharu Harada | Family Medicine | 301 N 8th, Pav-3a158, Springfield, IL 62701 | 2007-05-02 |
| 1427131127 | Radiological Associates of Decatur | Radiology | 319 E Madison Suite J, Springfield Mri & Imaging Center, Springfield, IL 62701 | 2006-10-24 |
| 1669498606 | Independence Holding Co LLC | Pharmacy | 201 North 5th Street, Springfield, IL 62701 | 2006-07-14 |
| 1720070238 | Neil J. Thomas | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 619 E Mason St Ste 4p57, Springfield, IL 62701 | 2005-08-19 |
| 1588187397 | Andrea Nicole Bloodworth | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701 | 2017-07-24 |
| Find all providers in zip 62701 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871122168 | Alexandra Emmanuelle Rochman | Physician Assistant | 54 W Crystal Brook Dr, Springfield, MA 01118-1946 | 2020-04-07 |
| 1740740737 | Western New England University | Physician Assistant | 215 Wilbraham Road, Springfield, MA 01119 | 2019-03-25 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| 1770850216 | Lauren Jennifer Navas | Physician Assistant | 100 River St Ste 2, Springfield, VT 05156-2930 | 2011-11-29 |
| 1295885168 | Jacqueline Kernaghan | Physician Assistant | 723 Saxer Ave, Springfield, PA 19064-3503 | 2007-01-11 |
| 1295746733 | Gwen Wright | Physician Assistant | 194 W Sproul Rd, Suite 105, Springfield, PA 19064-2027 | 2006-08-10 |
| 1164490710 | Stacie L Pierce | Physician Assistant | 3721 W El Castile St, Springfield, MO 65807-5431 | 2006-03-09 |
| 1245206432 | Annette K Bates | Physician Assistant | 819 Worcester St Ste 3, Springfield, MA 01151-1056 | 2006-02-27 |
| 1518947159 | Louis Patrick Favata | Physician Assistant | 140 High St., Springfield, MA 01199 | 2006-01-19 |
| 1649257031 | Scott D Rubin | Physician Assistant | 3400 Main Street, Springfield, MA 01107-1113 | 2005-12-27 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62701 |
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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.