MARILLEN L WELLS (NPI# 1619989555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619989555 |
| Entity Type | Individual |
| Full Name | MARILLEN L WELLS |
| Practice Address |
3307 Broadway St Ste 140 Mount Vernon IL 62864-2347 |
| Mailing Address |
Rr 1 Box 125b Dahlgren IL 62828-9781 |
| Practice Telephone | 6182447200 |
| Practice Fax Number | 6182447274 |
| Mailing Telephone | 6182370148 |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | IL | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | CDR | 810868 | 01 |
| Street Address |
3307 BROADWAY ST STE 140 |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-2347 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790713899 | Veena Kawatra Gupta | Family Medicine | 3307 Broadway St, Ste 140, Mount Vernon, IL 62864-2347 | 2006-06-28 |
| 1033491444 | Lormed LLC | Durable Medical Equipment & Medical Supplies | 3307 Broadway St, Suite 150, Mount Vernon, IL 62864-2387 | 2011-09-12 |
| 1285850396 | Brad Mcmillin, Inc | Hearing Aid Equipment | 3307 Broadway St, Suite 160, Mount Vernon, IL 62864-2347 | 2007-04-17 |
| 1346376274 | James Edward Keeler | Physician Assistant | 3307 Broadway St, Suite 140, Mount Vernon, IL 62864-2347 | 2007-02-26 |
| 1508917543 | Kenneth C Smith | Physical Therapist | 3307 Broadway St, Suite 140, Mount Vernon, IL 62864-2347 | 2007-01-16 |
| 1649283870 | Physician Rural Health Clinic of Jefferson County | Clinic/Center | 3307 Broadway St, Ste 130, Mount Vernon, IL 62864-2347 | 2006-08-15 |
| 1598777435 | Care First Medical Center | Family Medicine | 3307 Broadway St, Ste 140, Mount Vernon, IL 62864-2347 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245843291 | Lindsay Gabbard | Dietitian, Registered | 115 Eddie Dr, Mount Vernon, KY 40456-7574 | 2020-08-28 |
| 1619506342 | Melissa Pfeiffer | Dietitian, Registered | 6040 Ford Rd N, Mount Vernon, IN 47620-7305 | 2020-04-04 |
| 1245873868 | Lori A Kaley | Dietitian, Registered | 689 Wings Mills Rd, Mount Vernon, ME 04352-3807 | 2019-10-27 |
| 1831411586 | Sarimin Rivera Llavona | Dietitian, Registered | 4501 Broadway St, Mount Vernon, WA 98274-3003 | 2010-02-23 |
| 1477504470 | Desiree Ann Webster | Dietitian, Registered | 1223 E Division St, Mount Vernon, WA 98274-4101 | 2006-05-14 |
| 1902439136 | Ashlie Cole | Dietitian, Registered | 5 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2020-02-17 |
| 1063059632 | Alice Green | Dietitian, Registered | 5 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2019-12-03 |
| 1033751169 | Zahava G Roth | Dietitian, Registered | 1 Wartburg Pl, Mount Vernon, NY 10552-3821 | 2019-10-09 |
| 1518370295 | Yedidah Tamar Yehudah | Dietitian, Registered | 121 Vernon Ave, Mount Vernon, NY 10553-1811 | 2014-06-10 |
| 1760781322 | Diane C Marx | Dietitian, Registered | 330 Pacific Pl, Mount Vernon, WA 98273-5427 | 2011-03-22 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
Please comment or provide details below to improve the information on MARILLEN L WELLS.
| 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.