JUDITH LIDY (NPI# 1588770424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588770424 |
| Entity Type | Individual |
| Full Name | JUDITH LIDY |
| Other Name | JUDITH LIDY |
| Credential | FNP |
| Practice Address |
506 W Lincoln Ave Suite 200 A Charleston IL 61920-2453 |
| Practice Telephone | 2173488727 |
| Mailing Telephone | 2173488727 |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2017-02-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209-000974 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
506 W LINCOLN AVE SUITE 200 A |
| City | CHARLESTON |
| State | IL |
| Zip Code | 61920-2453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912981390 | David C. Hunter | Counselor | 506 W Lincoln Ave, Suite 1000, Charleston, IL 61920-2453 | 2005-11-30 |
| 1881055184 | Holly Godden | Counselor | 506 W Lincoln Ave, Suite 500, Charleston, IL 61920-2453 | 2016-03-14 |
| 1770905952 | Charleston Primary Care Inc. | Clinic/Center | 506 W Lincoln Ave, Suite 200, Charleston, IL 61920-2453 | 2014-01-07 |
| 1497942791 | L.e. Mcneill, Md Sc | Family Medicine | 506 W Lincoln Ave, Suites 200a&b, Charleston, IL 61920-2453 | 2007-10-01 |
| 1790976017 | Jane Elizabeth Wilson | Counselor | 506 W Lincoln Ave, Suite 1000, Charleston, IL 61920-2453 | 2007-08-05 |
| 1346456068 | Virginia Alberta Croft | Speech-Language Pathologist | 506 W Lincoln Ave, Charleston, IL 61920-2453 | 2007-05-16 |
| 1659441210 | New Leaf Professional Counseling | Counselor | 506 W Lincoln Ave, Suite 1000, Charleston, IL 61920-2453 | 2006-11-09 |
| 1891897773 | Leland E. Mcneill | Family Medicine | 506 W Lincoln Ave, Suites 200 A and B, Charleston, IL 61920-2453 | 2006-09-02 |
| 1396853008 | Jason B Jerabek | Family Medicine | 506 W Lincoln Ave, Suite 200 A, Charleston, IL 61920-2453 | 2006-08-25 |
| 1619953189 | Beverly J. Voris | Counselor | 506 W Lincoln Ave, Suite 400, Charleston, IL 61920-2453 | 2005-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124643879 | Jenna Kay Mortensen | Speech-Language Pathologist | 2086 7th Street, Charleston, IL 61920 | 2020-06-09 |
| 1255954566 | Christina L. White | Nurse Practitioner | 1199 Persimmon Rd, Charleston, IL 61920 | 2020-05-20 |
| 1679066773 | Jennifer Hess | Specialist/Technologist | 2506 Lantz Building, Charleston, IL 61920 | 2018-06-13 |
| 1134647969 | Nichole C Ogilvie | Student in an Organized Health Care Education/Training Program | 917 4th Street Apt 19, Charleston, IL 61920 | 2017-08-31 |
| 1467970319 | Marcus Roach | Physical Therapy Assistant | 912 Oakcrest Dr. Apt D, Charleston, IL 61920 | 2017-08-30 |
| 1114478500 | 5 Guys Rx II LLC | Pharmacy | 1 W Lincoln Ave, Charleston, IL 61920 | 2016-10-20 |
| 1649723206 | Bright Minds Educational Program Inc | Developmental Therapist | 7704 Deerpath Road, Charleston, IL 61920 | 2016-08-01 |
| 1760843379 | Lisa Price | Nurse Practitioner | 2040 Lincoln Ave, Suite 100, Charleston, IL 61920 | 2016-03-09 |
| 1104243385 | Nathan David Schwartzkopf | Specialist/Technologist | 1340 A Street, Charleston, IL 61920 | 2014-03-25 |
| 1558694349 | Emily Schilling | Specialist/Technologist | 2350 Harrison Avenue, Charelston, IL 61920 | 2009-09-10 |
| Find all providers in zip 61920 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417557737 | Diondra Johnson | Nurse Practitioner | 2327 Watchtower Ln, Charleston, SC 29414-7803 | 2020-10-27 |
| 1427656735 | Kisha Lanece James | Nurse Practitioner | 16 Red Mulberry Way Apt 3, Charleston, WV 25306-0107 | 2020-10-09 |
| 1043822216 | Amber Bagwell | Nurse Practitioner | 442 King St Fl 2, Charleston, SC 29403-6230 | 2020-08-19 |
| 1790396273 | Amanda Jo Grant | Nurse Practitioner | 2207 Seneca Dr, Charleston, IL 61920-3836 | 2020-08-10 |
| 1811514961 | Isabel Margarita Lemasters | Nurse Practitioner | 3226 Moonlight Dr, Charleston, SC 29414-8052 | 2020-07-05 |
| 1255954566 | Christina L. White | Nurse Practitioner | 1199 Persimmon Rd, Charleston, IL 61920 | 2020-05-20 |
| 1770123929 | Catherine A. Woods | Nurse Practitioner | 9313 Medical Plaza Dr Ste 310, Charleston, SC 29406-9197 | 2020-01-15 |
| 1104464999 | Brittany D Griffith | Nurse Practitioner | 830 Pennsylvania Ave Ste 402, Charleston, WV 25302-3390 | 2019-12-12 |
| 1437795747 | Brigitte Britt Huttemeyer | Nurse Practitioner | 678 Castle Pinckney Dr, Charleston, SC 29412 | 2019-11-21 |
| 1124660774 | Dennis Robert Moore | Nurse Practitioner | 4610 Kanawha Ave Sw Ste 302, Charleston, WV 25309-1367 | 2019-10-16 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 61920 |
Please comment or provide details below to improve the information on JUDITH LIDY.
| 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.