ANDREA NICOLE BLOODWORTH (NPI# 1588187397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588187397 |
| Entity Type | Individual |
| Full Name | ANDREA NICOLE BLOODWORTH |
| Credential | APN, BSN, RN |
| Practice Address |
619 E Mason St Ste 4p57 Springfield IL 62701 |
| Mailing Address |
619 E Mason St Ste 4p57 Springfield IL 62701-1034 |
| Practice Telephone | 2177880706 |
| Mailing Telephone | 2177880706 |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2019-04-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
209016698 | IL | Allopathic & Osteopathic Physicians |
| Y | 363L00000X | Nurse Practitioner | 209016698 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 800 E Carpenter St, Springfield, IL 627691000 | 2175446464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639717853 | Andrea Bloodworth | Peer Specialist | 3625 Youree Dr, Shreveport, LA 71105-2121 | 2019-12-18 |
| Street Address |
619 E MASON ST STE 4P57 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720070238 | Neil J. Thomas | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 619 E Mason St Ste 4p57, Springfield, IL 62701 | 2005-08-19 |
| 1992227417 | Megan D Siegrist | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701-1034 | 2017-07-17 |
| 1518405588 | Waleed Alharbi | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701-1034 | 2017-02-09 |
| 1346653656 | Kevin Alexander Graham | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 619 E Mason St Ste 4p57, Springfield, IL 62701-1034 | 2014-06-04 |
| 1700134087 | Nadia El Hangouche | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701-1034 | 2012-08-17 |
| 1982969960 | Arti Singh | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701-1034 | 2012-07-06 |
| 1801159264 | Jennifer Davis | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701-1034 | 2012-06-20 |
| 1346539467 | Mark Jung-ching Shen | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701 | 2011-03-29 |
| 1619278074 | Wesley Brian Zwiefel | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701-1034 | 2010-11-16 |
| 1700199445 | Bharath Rajagopalan | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701-1034 | 2010-07-22 |
| 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 |
| 1174075147 | Loralee Donnelly | Nurse Practitioner | 301 N 8th St, Springfield, IL 62701 | 2016-10-26 |
| 1871945725 | Ashley R Bell | Nurse Practitioner | 319 E Madison St Ste 1f, Springfield, IL 62701 | 2016-07-04 |
| Find all providers in zip 62701 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
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|---|---|---|---|---|
| 1578178422 | Behishta Ishanzai | Nurse Practitioner | 7500 Geoint Dr, Springfield, VA 22150-7500 | 2020-09-08 |
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1255951331 | Bryndi Raye Shirley | Nurse Practitioner | 1636 S Glenstone Ave Ste 100, Springfield, MO 65804-1527 | 2020-04-20 |
| 1750900379 | Gemma Nicole D'angelo | Nurse Practitioner | 996 Stoneybrook Dr, Springfield, PA 19064-3829 | 2020-04-14 |
| 1629607882 | Melanie Herrin | Nurse Practitioner | 6230 Rolling Rd Ste J, Springfield, VA 22152-2326 | 2020-04-08 |
| 1871133520 | Deborah Ann Tully | Nurse Practitioner | 2 Medical Center Dr Ste 202, Springfield, MA 01107-1272 | 2020-01-10 |
| 1932759651 | Amanda Couchon | Nurse Practitioner | 759 Chestnut St Radiology Department, Springfield, MA 01199-0001 | 2019-09-14 |
| 1760947410 | Andrea K Leger | Nurse Practitioner | 300 Birnie Ave Ste 102, Springfield, MA 01107-1375 | 2019-02-07 |
| 1417421579 | Stephanie M Yeager | Nurse Practitioner | 3850 S National Ave Ste 700, Springfield, MO 65807-5292 | 2019-01-11 |
| 1215415799 | Bree Schmulbach | Nurse Practitioner | Bsb Room 20, Springfield, IL 62703 | 2018-08-06 |
| 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.