MARY AMANDA PITTMAN


Address: 715 Broadway St, Gillespie, IL 62033-1166
Phone: 2178394491

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
209013952 IL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
IL ST OF IL LICENSE NUMBER 209013952 01

Other Providers MARY PITTMAN

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

Office Location

Street Address 715 BROADWAY ST
City GILLESPIE
State IL
Zip Code 62033-1166

Providers in the same location

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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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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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Competitor

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City GILLESPIE
Zip Code 62033

Improve Information

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Dataset Information

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.

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