HAROLD WAYNE DUCKETT (NPI# 1700414950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700414950 |
| Entity Type | Individual |
| Full Name | HAROLD WAYNE DUCKETT |
| Practice Address |
1801 15th Street Pl Moline IL 61265-3964 |
| Practice Telephone | 3097644477 |
| Mailing Telephone | 3097644477 |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2020-03-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224P00000X | Prosthetist | 006054891 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1801 15TH STREET PL |
| City | MOLINE |
| State | IL |
| Zip Code | 61265-3964 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861035438 | Ora Orthopedics, PC | Orthopaedic Surgery | 510 Valley View Drive, Moline, IL 61265 | 2019-10-25 |
| 1598231698 | Secure Dental Vi | Dentist | 106 16th St, Unit #90, Moline, IL 61265 | 2018-10-17 |
| 1487152088 | Fjellheim P.c | Chiropractor | 1535 47th Avenue, Suite 5, Moline, IL 61265 | 2018-01-29 |
| 1326567199 | Elizabeth Ann Teichler | Respiratory Therapist, Registered | 4360 7th Street, Moline, IL 61265 | 2017-09-13 |
| 1497279913 | Caroline M Mather | Behavioral Analyst | 2430 6th Avenue, Moline, IL 61265 | 2017-07-26 |
| 1639625239 | Elizabeth Anderson | Nurse's Aide | 4319 26th Ave Apt 1, Moline, IL 61265 | 2016-09-01 |
| 1437604154 | Lindsey Bollaert | Nurse Practitioner | 1100 36th Ave, Moline, IL 61265 | 2016-08-23 |
| 1437541869 | Divvymed, LLC | Pharmacy | 4300 44th Ave, Moline, IL 61265 | 2015-02-23 |
| 1477955250 | Todd Stone | Nurse Practitioner | 1100 3th Avenue, Moline, IL 61265 | 2014-09-23 |
| 1588084479 | Familia Dental Moline LLC | Dentist | 1102 4th Ave, Moline, IL 61265 | 2014-04-18 |
| Find all providers in zip 61265 | ||||
| Taxonomy Code | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225653330 | Eduardo Arias | Prosthetist | 811 S Paulina St Ste 161, Chicago, IL 60612-4353 | 2020-06-15 |
| 1063041036 | Tanyale Allen | Prosthetist | 1016 E 156th Pl, Dolton, IL 60419-2775 | 2020-04-02 |
| 1598395535 | Samira Kamran | Prosthetist | 211 E Ohio St Apt 2505, Chicago, IL 60611-3257 | 2020-01-17 |
| 1558906065 | Meilani Schaeffer | Prosthetist | 11317 W 159th St, Orland Park, IL 60467-5659 | 2019-11-08 |
| 1124586078 | Kaiisha Dear Sweet | Prosthetist | 3408 W 95th St, Evergreen Park, IL 60805-2204 | 2019-03-11 |
| 1851859706 | Keisha Shavonne Jackson-murry | Prosthetist | 812 Gladstone Dr, Vernon Hills, IL 60061-1406 | 2019-03-11 |
| 1811461437 | Debria Filer | Prosthetist | 16126 S Park Ave, South Holland, IL 60473-1581 | 2019-01-16 |
| 1053813089 | James Paul Shrader | Prosthetist | 1551 Bond Street, Suite 111, Naperville, IL 60563 | 2018-03-06 |
| 1144738519 | Taisha Worlds | Prosthetist | 2745 Bristol Dr, Lisle, IL 60532-4215 | 2018-01-18 |
| 1215455852 | Bethany Banks | Prosthetist | 9161 W. Cermak Rd, North Riveride, IL 60546 | 2017-09-04 |
| Find all providers with the same taxonomy | ||||
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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.