MARY AMANDA PITTMAN (NPI# 1609238518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1609238518 |
Entity Type | Individual |
Full Name | MARY AMANDA PITTMAN |
Practice Address |
715 Broadway St Gillespie IL 62033-1166 |
Practice Telephone | 2178394491 |
Mailing Telephone | 2178394491 |
Enumeration Date | 2016-03-22 |
Last Update Date | 2016-03-22 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209013952 | IL | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | ST OF IL LICENSE NUMBER | 209013952 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659930022 | Mary Jane Pittman | Pharmacist | 3521 Sw Wilshire Blvd, Joshua, TX 76058-6195 | 2019-06-10 |
1730300682 | Mary Ann Pittman | Dentist | 1015 58th Street North, St. Petersburg, FL 33710-6326 | 2007-05-01 |
1184746943 | Mary Pittman | Social Worker | 10537 S Roberts Rd, Palos Hills, IL 60465-1933 | 2007-04-04 |
Street Address |
715 BROADWAY ST |
City | GILLESPIE |
State | IL |
Zip Code | 62033-1166 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609870591 | Bruce Frank Weber | Family Medicine | 715 Broadway St, Gillespie, IL 62033-1166 | 2005-06-08 |
1245706548 | Samantha Kay Rogers | Nurse Practitioner | 715 Broadway St, Gillespie, IL 62033-1166 | 2018-10-15 |
1811389935 | Hollie Trettenero | Nurse Practitioner | 715 Broadway St, Gillespie, IL 62033-1166 | 2015-02-26 |
1497994727 | Jaclyn Joy Hake | Physician Assistant | 715 Broadway St, Gillespie, IL 62033-1166 | 2009-02-10 |
1194915074 | Macoupin Family Practice Center, LLP | Family Medicine | 715 Broadway St, Gillespie, IL 62033-1166 | 2007-07-27 |
1568652436 | Macoupin Family Practice Centers, LLP | Family Medicine | 715 Broadway St, Gillespie, IL 62033-1166 | 2007-07-27 |
1699899070 | Macoupin Family Practice Centers LLP | Family Medicine | 715 Broadway St, Gillespie, IL 62033-1166 | 2007-03-19 |
1477586121 | Jason K Manthei | Physician Assistant | 715 Broadway St, Gillespie, IL 62033-1166 | 2006-07-08 |
1992709984 | Chris Philip Poirot | Family Medicine | 715 Broadway St, Gillespie, IL 62033-1166 | 2005-06-08 |
1417951401 | Brian Lee Quarton | Family Medicine | 715 Broadway St, Gillespie, IL 62033-1166 | 2005-06-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225596950 | Laura Michelle Halpin | Physical Therapist | 607 Litchfield Road, Gillespie, IL 62033 | 2019-03-12 |
1770942716 | Carol Candler | Nurse Practitioner | 109 East Maple Street, Maucoupin County Maple Street Clinic, Gillespie, IL 62033 | 2016-02-18 |
1932519618 | Terry Allan | Pharmacist | 113 South Macoupin Street, Gillespie, IL 62033 | 2014-05-02 |
1649414558 | Bernadette Kathlene Sobczak | Nurse Practitioner | 807 Broadway, Gillespie, IL 62033 | 2009-04-22 |
1376765206 | Sheri Lynne Banovic | Nurse Practitioner | 115 South Macoupin Street, Gillespie, IL 62033 | 2007-05-02 |
1215044920 | James Paul Verton | Pharmacist | 120 S Macoupin, Dippold Drug Co Inc, Gillespie, IL 62033 | 2006-08-25 |
1427575612 | Beth Lynn Sies | Speech-Language Pathologist | 340 Kelly St, Gillespie, IL 62033 | 2017-08-28 |
1356599971 | Julia Terese Ruckman | Social Worker | 109 E Maple St, Gillespie, IL 62033 | 2008-09-08 |
1124135835 | Bruce W Hughes | Pharmacist | 120 S Macoupin, Dippold Drug Co Inc, Gillespie, IL 62033 | 2006-08-25 |
1407474083 | Staten Family Practice Pllc | Clinic/Center | 500 W Virginia Ave, Gillespie, IL 62033-1025 | 2020-07-09 |
Find all providers in zip 62033 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770942716 | Carol Candler | Nurse Practitioner | 109 East Maple Street, Maucoupin County Maple Street Clinic, Gillespie, IL 62033 | 2016-02-18 |
1376765206 | Sheri Lynne Banovic | Nurse Practitioner | 115 South Macoupin Street, Gillespie, IL 62033 | 2007-05-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538760277 | Jennifer Michelle Kennedy | Nurse Practitioner | 3006 Lakeview Dr, Metropolis, IL 62960-3119 | 2020-11-07 |
1881295541 | Britney Julia Durst | Nurse Practitioner | 5905 N Prospect Rd, Peoria, IL 61614-4311 | 2020-11-07 |
1952902884 | Julia Ann Gottschalk | Nurse Practitioner | 1979 Mcdowell Rd, Unit 103, Naperville, IL 60563 | 2020-11-06 |
1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
1598365140 | Caitlyn Windsor | Nurse Practitioner | 24525 Grange Rd, Geneseo, IL 61254-8429 | 2020-10-31 |
1578163515 | Deanna Bassette | Nurse Practitioner | 243 E 31st St Apt 401, Chicago, IL 60616-5212 | 2020-10-29 |
1891395745 | Vrunda Shah Patel | Nurse Practitioner | 933 W Van Buren St Apt 502, Chicago, IL 60607-3583 | 2020-10-29 |
1346840337 | Catherine Suh | Nurse Practitioner | 1380 Marcy Ln, Wheeling, IL 60090-4422 | 2020-10-28 |
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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.