MRS. MARILYN STOMBAUGH (NPI# 1669559290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669559290 |
| Entity Type | Individual |
| Full Name | MRS. MARILYN STOMBAUGH |
| Credential | PA-C |
| Practice Address |
4107 S Water Tower Pl Mount Vernon IL 62864-6293 |
| Mailing Address |
14739 N County Farm Ln Mount Vernon IL 62864-9895 |
| Practice Telephone | 6182440031 |
| Mailing Telephone | 6182419619 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4107 S WATER TOWER PL |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-6293 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215902986 | George T Nahass | Dermatology | 4107 S Water Tower Pl, Mount Vernon, IL 62864-6293 | 2006-02-17 |
| 1578039707 | Tina Hall | Registered Nurse | 4107 S Water Tower Pl, Mount Vernon, IL 62864-6293 | 2018-10-15 |
| 1467955179 | United Skin Specialists Illinois Ltd, PC | Dermatology | 4107 S Water Tower Pl, Mount Vernon, IL 62864-6293 | 2018-03-09 |
| 1194225268 | United Skin Specialists Illinois Ltd, PC | Dermatology | 4107 S Water Tower Pl, Mount Vernon, IL 62864-6293 | 2018-02-15 |
| 1083015689 | Natalie Amason | Dermatology | 4107 S Water Tower Pl, Mount Vernon, IL 62864 | 2014-09-15 |
| 1669599841 | Skin Care Center of Southern Il LLC | Dermatology | 4107 S Water Tower Pl, Mount Vernon, IL 62864-6293 | 2007-03-23 |
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609898295 | Franklin Emergency Medicine Associates Pa | Physician Assistant | 500 S State Highway 37, Mount Vernon, TX 75457 | 2006-07-24 |
| 1679562136 | Casondra A Banks | Physician Assistant | 1600 Continental Pl, #101, Mount Vernon, WA 98273-5607 | 2005-10-18 |
| 1912504424 | Laura Vanessa Sanchez | Physician Assistant | 12 N 7th Ave, Mount Vernon, NY 10550-2026 | 2020-10-07 |
| 1750997433 | Katie Akane Kaestner | Physician Assistant | 1400 E Kincaid St, Mount Vernon, WA 98274-4127 | 2020-09-18 |
| 1295107670 | John David Carlin | Physician Assistant | 1400 E Kincaid St, Mount Vernon, WA 98274-4127 | 2015-10-26 |
| 1679979157 | Michael Murray | Physician Assistant | 4117 S Water Tower Pl, Suite D, Mount Vernon, IL 62864-6567 | 2014-11-12 |
| 1215353636 | Kristiana L Brown | Physician Assistant | 10 Woodlake Trl Ste C, Mount Vernon, OH 43050-9573 | 2014-03-10 |
| 1003066432 | Courtney A. Shick | Physician Assistant | 1311 E. Division Street, Mount Vernon, WA 98274 | 2008-09-22 |
| 1538345285 | Julie R. Heath | Physician Assistant | 1400 E Kincaid St, Mount Vernon, WA 98274-4127 | 2008-01-11 |
| 1831394782 | Julie A Lampley-douglass | Physician Assistant | 4105 N Water Tower Pl, Mount Vernon, IL 62864-6296 | 2007-06-20 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
Please comment or provide details below to improve the information on MRS. MARILYN STOMBAUGH.
| 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.