HEIDI DAWN DUFF (NPI# 1588855381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1588855381 |
Entity Type | Individual |
Full Name | HEIDI DAWN DUFF |
Credential | PA-C |
Practice Address |
6800 State Route 162 Maryville IL 62062-8500 |
Mailing Address |
12101 Woodcrest Executive Dr Suite 210 Saint Louis MO 63141-5047 |
Practice Telephone | 3143170600 |
Practice Fax Number | 3143170606 |
Mailing Telephone | 3143170600 |
Mailing Fax Number | 3143170606 |
Enumeration Date | 2007-08-06 |
Last Update Date | 2015-03-10 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085003013 | IL | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
6800 STATE ROUTE 162 |
City | MARYVILLE |
State | IL |
Zip Code | 62062-8500 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588666804 | Legatus Emergency Services LLC | Emergency Medicine | 6800 State Route 162, Maryville, IL 62062-8500 | 2005-06-01 |
1598373052 | Brittany Smith | Nurse Anesthetist, Certified Registered | 6800 State Route 162, Maryville, IL 62062-8500 | 2020-07-21 |
1285251033 | Cory Ray Austin | Nurse Anesthetist, Certified Registered | 6800 State Route 162, Maryville, IL 62062-8500 | 2020-06-28 |
1043856701 | Mallory Jean Stimac | Physician Assistant | 6800 State Route 162, Maryville, IL 62062-8521 | 2019-11-18 |
1023577442 | Christie Marie Keen | Nurse Practitioner | 6800 State Route 162, Maryville, IL 62062-8521 | 2019-03-15 |
1437623287 | Teressa Vigil | Occupational Therapist | 6800 State Route 162, Maryville, IL 62062-8500 | 2019-01-15 |
1891268355 | Eric Michael Watson | Physician Assistant | 6800 State Route 162, Maryville, IL 62062-8521 | 2019-01-08 |
1649748831 | Mary Holowatuk | Occupational Therapist | 6800 State Route 162, Maryville, IL 62062-8521 | 2018-11-06 |
1558846741 | Cori Warren | Occupational Therapist | 6800 State Route 162, Maryville, IL 62062-8500 | 2018-10-03 |
1134604366 | Anna Mcnamara | Physical Therapist | 6800 State Route 162, Maryville, IL 62062-8500 | 2018-10-03 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104325091 | Jennifer M Oyler | Physician Assistant | 6812 State Route 162 Suite 120, Maryville, IL 62062 | 2018-02-06 |
1710495965 | Sarah Elizabeth Barto | Family Medicine | 2133 Vadalabene Drive, Suite Sb, Maryville, IL 62062 | 2018-01-22 |
1104348085 | Lindsey Nicole Langendorf | Chiropractor | 62 Executive Plaza Ct, Maryville, IL 62062 | 2017-07-12 |
1043750540 | Gina Saal | Nurse Anesthetist, Certified Registered | 6800 Rt 162, Maryville, IL 62062 | 2017-03-02 |
1548657737 | Karen Michelle Bertels | Emergency Medicine | 6800 Il - 162, Maryville, IL 62062 | 2015-04-25 |
1811258148 | Debra Ann Hoelscher | Internal Medicine | 2102 Vadalabene, Maryville, IL 62062 | 2012-06-04 |
1538438445 | Casey Elizabeth Wiesemeyer | Speech-Language Pathologist | 2201 Copper Creek Rd, Maryville, IL 62062 | 2011-12-21 |
1407144819 | Norah Claire Farley Baker | Family Medicine | 10 Professional Park Dr., Maryville, IL 62062 | 2011-07-19 |
1891092474 | Kimberly M Schneider | Physician Assistant | 20b Professional Park Drive, Maryville, IL 62062 | 2011-02-17 |
1669782397 | Purandhri Patel | Physical Therapist | 6820 State Route 162, Maryville, IL 62062 | 2010-10-15 |
Find all providers in zip 62062 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093152688 | Chelsey C Henry | Physician Assistant | 2217 E Lamar Alexander Pkwy, Maryville, TN 37804-5311 | 2013-05-23 |
1942497037 | Abby Marie Beedy | Physician Assistant | 20 Professional Park Dr Ste B, Maryville, IL 62062-5830 | 2007-10-02 |
1619095270 | Kelly Marti | Physician Assistant | 20 B Professional Park, Maryville, IL 62062 | 2007-03-26 |
1902330145 | Kate Pryor Galbraith | Physician Assistant | 907 E Lamar Alexander Pkwy, Maryville, TN 37804-5015 | 2017-04-14 |
1912398025 | Kasaundra Rae Heiberger | Physician Assistant | 6812 State Route 162 Ste 120, Maryville, IL 62062-8586 | 2015-02-11 |
1366846735 | Heather L. Thompson | Physician Assistant | 1103 E Lamar Alexander Pkwy, Maryville, TN 37804-5130 | 2014-10-14 |
1033452107 | Stephen M Broaddus | Physician Assistant | 6800 State Route 162, Maryville, IL 62062-8500 | 2013-03-27 |
1124277389 | Christine Werner | Physician Assistant | 2704 N Center St, Maryville, IL 62062-5624 | 2008-09-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831707298 | Eliza Ballen | Physician Assistant | 335 Sylvan Rd, Lake Bluff, IL 60044-2562 | 2020-07-21 |
1477177947 | Rybecca Janovyak | Physician Assistant | 14432 High Rd, Lockport, IL 60441-9402 | 2020-06-01 |
1518591759 | Julie Jenkot | Physician Assistant | 333 N Michigan Ave Fl 14, Chicago, IL 60601-3901 | 2020-02-26 |
1801429873 | Hinjal D Jha | Physician Assistant | 22285 N Pepper Rd Ste 409, Lake Barrington, IL 60010-2542 | 2020-02-19 |
1770120222 | Alvina Shaikh | Physician Assistant | 4009 Warren Ave, Bellwood, IL 60104-2066 | 2019-12-03 |
1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
1538705272 | Bethany Mae Frisby | Physician Assistant | 8630 W Golf Rd, Niles, IL 60714-5600 | 2019-11-18 |
1134761984 | Ella-marie Rakowski | Physician Assistant | 25 Acorn Dr, Hawthorn Woods, IL 60047-7407 | 2019-10-14 |
1467001859 | Timothy Omotayo Adesanya | Physician Assistant | Graham Correctional Center, 12078 Illinois Rte 185, Hilliboro, IL 62049 | 2019-09-09 |
1518514066 | Victoria Moore | Physician Assistant | 979 W Main St, West Dundee, IL 60118-2088 | 2019-08-20 |
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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.