NICHOLAS P MCKEOWN (NPI# 1609415454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609415454 |
| Entity Type | Individual |
| Full Name | NICHOLAS P MCKEOWN |
| Credential | PA-C |
| Practice Address |
5875 E Riverside Blvd Rockford IL 61114-4937 |
| Mailing Address |
Box 78534 Milwaukee WI 53278 |
| Practice Telephone | 8153989491 |
| Practice Fax Number | 8153817498 |
| Mailing Telephone | 8153989491 |
| Mailing Fax Number | 8153817498 |
| Enumeration Date | 2019-12-26 |
| Last Update Date | 2019-12-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5875 E RIVERSIDE BLVD |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61114-4937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134126451 | Zeeshan Ahmad | Physical Medicine & Rehabilitation | 5875 E Riverside Blvd, Rockford, IL 61114-4937 | 2005-07-01 |
| 1922646942 | Tori L Homb | Nurse Practitioner | 5875 E Riverside Blvd, Rockford, IL 61114-4937 | 2019-12-20 |
| 1285296459 | Arron Dennis Buck | Physical Therapist | 5875 E Riverside Blvd, Rockford, IL 61114-4937 | 2019-07-08 |
| 1740840404 | Midwest Integrated Surgeons, Pllc | Orthopaedic Surgery | 5875 E Riverside Blvd, Rockford, IL 61114-4937 | 2019-06-15 |
| 1659931319 | Spine Surgeons Integrated Pllc | Orthopaedic Surgery | 5875 E Riverside Blvd, Rockford, IL 61114-4937 | 2019-06-15 |
| 1255818894 | Rockford Orthopedic Associates, Ltd. Dba Orthoillinois Anesthesia | Anesthesiology | 5875 E Riverside Blvd, Rockford, IL 61114-4937 | 2018-07-26 |
| 1568908283 | Robert S. Meyers | Physician Assistant | 5875 E Riverside Blvd, Rockford, IL 61114-4937 | 2017-01-19 |
| 1427591726 | Raquel Ramirez | Registered Nurse | 5875 E Riverside Blvd, Rockford, IL 61114-4937 | 2016-11-18 |
| 1104374503 | Amanda S. Pumilia | Registered Nurse | 5875 E Riverside Blvd, Rockford, IL 61114-4937 | 2016-09-14 |
| 1619422516 | Rockford Orthopedic Associates, Ltd. | Durable Medical Equipment & Medical Supplies | 5875 E Riverside Blvd, Rockford, IL 61114-4937 | 2016-08-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064560 | Caleb Ifeoluwa Oluwadamisi | Student in an Organized Health Care Education/Training Program | Mercy Health Javon Bea Hospital, 8201 East Riverside Boulevard, Rockford, IL 61114 | 2020-05-11 |
| 1811525959 | Seifeldin Eid | Student in an Organized Health Care Education/Training Program | Mercyhealthjavon Bea Hospital, 8201, East Riversideboulevard, IL 61114 | 2020-04-01 |
| 1073167664 | Swedishamerican Hospital | Internal Medicine | 3505 N Bell School Road, Rockford, IL 61114 | 2019-07-31 |
| 1154980076 | Anurag Gill | Student in an Organized Health Care Education/Training Program | 8201 East Riverside Boulevard, Mercy Health Javon Bea Hospital, Rockford, IL 61114 | 2019-06-13 |
| 1578121943 | Sona Najafi | Student in an Organized Health Care Education/Training Program | Mercyhealth Javon Bea Hospital, 8201 East Riverside Blvd, Rockford, IL 61114 | 2019-05-31 |
| 1760045744 | Julianna Jones | Counselor | 6653 Weaver Rd Ste 115, Rockford, IL 61114 | 2019-04-16 |
| 1952869943 | Angela Marie Hawkins | Nurse Practitioner | 8201 E. Riverside Blvd, Pediatric Neurology, Rockford, IL 61114 | 2019-03-08 |
| 1376029231 | Meghan Beth Teske | Chiropractor | 3779 N. Alpine Rd., Rockfod, IL 61114 | 2018-07-13 |
| 1811401284 | Summit Radiology, LLC | Clinic/Center | 3849 N. Perryville Road, Rockford, IL 61114 | 2017-11-21 |
| 1548704299 | Rockford Orthopedic Associates, Ltd | Durable Medical Equipment & Medical Supplies | 5929 E Riverside Blvd, Rockford, IL 61114 | 2016-12-15 |
| Find all providers in zip 61114 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871063776 | Amira Al-basha | Physician Assistant | 1639 N Alpine Rd Ste 380, Rockford, IL 61107-1440 | 2018-12-04 |
| 1578042982 | Alyssa Margaret Vasylyuk | Physician Assistant | 2350 N Rockton Ave Fl 4, Rockford, IL 61103-3600 | 2018-08-08 |
| 1053778456 | Jamie Anticevich | Physician Assistant | 6595 East State Street, Rockford, IL 61108-2542 | 2016-01-15 |
| 1437534666 | Irene Dyer | Physician Assistant | 1560 Red Oak Ln, Rockford, IL 61107-2767 | 2015-07-29 |
| 1215250675 | Krista R Mohamed | Physician Assistant | 1401 E. State St., Swedish American Hospital, Rockford, IL 61104-2315 | 2010-03-12 |
| 1629121009 | Jason A. Kadar | Physician Assistant | 2902 Mcfarland Rd Ste 300, Rockford, IL 61107-6801 | 2007-01-19 |
| 1295805851 | Kristin Lynn King-shank | Physician Assistant | 171 Dogwood Dr Ne, Rockford, MI 49341-7361 | 2006-11-09 |
| 1245263268 | William John Stout | Physician Assistant | 1401 E State Street, Rockford, IL 61104 | 2006-07-10 |
| 1952356040 | Saint Anthony Medical Center | Physician Assistant | 6830 Villagreen Vw, Rockford, IL 61107-5639 | 2006-05-24 |
| 1972552131 | Andrea B Fulcomer | Physician Assistant | 2404 Charles St, Rockford, IL 61108-1602 | 2006-05-08 |
| Find all providers in ROCKFORD | ||||
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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.