MIDWEST EMERGENCY GOOD SAMARITAN, INC (NPI# 1629367578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629367578 |
| Entity Type | Organization |
| Organization Name | MIDWEST EMERGENCY GOOD SAMARITAN, INC |
| Practice Address |
605 N 12th St Mount Vernon IL 62864-2857 |
| Mailing Address |
6451 Brentwood Stair Road Suite 202 Fort Worth TX 76112-3200 |
| Practice Telephone | 8174514208 |
| Practice Fax Number | 8175633699 |
| Mailing Telephone | 8174514208 |
| Mailing Fax Number | 8175633699 |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2011-03-31 |
| Authorized Official Name | DR. WILLIAM W CRUZEN (PRESIDENT) |
| Authorized Official Telephone | 8174514208 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
605 N 12TH ST |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-2857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447266507 | Prince B Oliver Jr. | Anesthesiology | 605 N 12th St, Mount Vernon, IL 62864-2857 | 2006-07-31 |
| 1528394335 | Katelyn Marie Lewis | Speech-Language Pathologist | 605 N 12th St, Mount Vernon, IL 62864-2857 | 2009-10-29 |
| 1538398680 | Michael Ambrose | Chiropractor | 605 N 12th St, Mount Vernon, IL 62864 | 2009-07-10 |
| 1295975837 | Sterling Emergency Physicians of Illinois, S.c | Physician Assistant | 605 N 12th St, Mount Vernon, IL 62864-2857 | 2009-02-23 |
| 1316108970 | Zachary R Gustavison | Physician Assistant | 605 N 12th St, Mount Vernon, IL 62864-2857 | 2008-06-17 |
| 1871773879 | Thomas J. Cain | Nurse Anesthetist, Certified Registered | 605 N 12th St, Mount Vernon, IL 62864-2857 | 2007-11-07 |
| 1508063405 | Advanced Internal Medicine, LLC | Internal Medicine | 605 N 12th St, Hospitalist Office, Mount Vernon, IL 62864-2857 | 2007-07-02 |
| 1215142310 | Douglas Elner Frankel | Emergency Medicine | 605 N 12th St, Mount Vernon, IL 62864-2857 | 2007-05-11 |
| 1659416923 | Amanda M Brown | Physical Therapist | 605 N 12th St, Mount Vernon, IL 62864-2857 | 2007-02-21 |
| 1184769465 | Justine Thole | Speech-Language Pathologist | 605 N 12th St, Mount Vernon, IL 62864-2857 | 2007-02-21 |
| Find all providers in the same location | ||||
| 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 | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649298779 | Michael Kevin Rowe | Emergency Medicine | 140 Newcomb Ave, Mount Vernon, KY 40456-2728 | 2006-07-17 |
| 1053343012 | Jeffrey S Gusky | Emergency Medicine | 500 S. State Hwy 37, Mount Vernon, TX 75457 | 2006-07-07 |
| 1740210749 | James F Neuenschwander II | Emergency Medicine | 1330 Coshocton Rd, Knox Community Hospital, Mount Vernon, OH 43050-1440 | 2006-07-04 |
| 1821027285 | Samuel N. Mark | Emergency Medicine | C/o Dr Abdulla. Medical Clinic, 12 North 7th Ave, Mount Vernon, NY 10550 | 2006-06-30 |
| 1316983109 | William F. Stewart | Emergency Medicine | 140 Newcomb Ave Ste 1, Mount Vernon, KY 40456-2726 | 2006-06-21 |
| 1366486235 | Christie Foster | Emergency Medicine | 1104 S 42nd St, Mount Vernon, IL 62864-6216 | 2006-06-15 |
| 1477510493 | Larry Ralph Nelson | Emergency Medicine | 809 S 15th St, Mount Vernon, WA 98274-4564 | 2006-04-26 |
| 1386607612 | Jena Marie Lopez | Emergency Medicine | 1415 E Kincaid Street, Mount Vernon, WA 98274-4126 | 2006-04-08 |
| 1801867205 | Robert F White | Emergency Medicine | 416 Kaufman St N, Mount Vernon, TX 75457-2116 | 2006-02-01 |
| 1821442179 | Midwest Emergency Good Samaritan | Emergency Medicine | 1 Good Samaritan Way, Mount Vernon, IL 62864-2402 | 2016-04-22 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
Please comment or provide details below to improve the information on MIDWEST EMERGENCY GOOD SAMARITAN, INC.
| 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.