CARRIE H PURDY (NPI# 1700499274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700499274 |
| Entity Type | Individual |
| Full Name | CARRIE H PURDY |
| Other Name | CARRIE H KALLAL |
| Credential | MSN APRN |
| Practice Address |
390 Maple Summit Rd Illini Bldg Jerseyville IL 62052 |
| Mailing Address |
5017 Staten Dr Godfrey IL 62035-1522 |
| Practice Telephone | 6184982101 |
| Practice Fax Number | 6184988153 |
| Mailing Telephone | 6189467674 |
| Mailing Fax Number | 6184988439 |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2020-08-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
209021821 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
390 MAPLE SUMMIT RD ILLINI BLDG |
| City | JERSEYVILLE |
| State | IL |
| Zip Code | 62052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326034919 | Srirama S Kurella | Internal Medicine | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2005-09-20 |
| 1124579099 | Mary Beck | Nurse Practitioner | 390 Maple Summit Rd, Jerseyville, IL 62052 | 2016-10-17 |
| 1811392970 | Jersey Community Hospital | Clinic/Center | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2014-10-30 |
| 1578901930 | Illini Medical Associates, Sc | Durable Medical Equipment & Medical Supplies | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2013-06-07 |
| 1598036071 | Krista E Jenkins | Physician Assistant | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2012-01-16 |
| 1023259967 | Victoria Ann Hargrave | Registered Nurse | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2009-03-22 |
| 1205090644 | Colleen M Canavan | Physician Assistant | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2008-07-15 |
| 1215062914 | Cynthia Barrett | Clinical Nurse Specialist | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2007-02-22 |
| 1053345488 | Deborah Marie Seymour | Nurse Practitioner | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2006-07-10 |
| 1013965698 | Illini Medical Associates Sc | Clinic/Center | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2006-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396265666 | Lauren Mccarthy | Podiatrist | 400 Maple Summit Rd Suite 200, Jerseyville, IL 62052 | 2017-06-27 |
| 1851757488 | German Insurance Agency | Local Education Agency (LEA) | 850 S State Street, Jerseyville, IL 62052 | 2016-01-12 |
| 1942584230 | Thomas G Honke | Pharmacist | 705 South State, Walgreens, Jerseyville, IL 62052 | 2011-10-05 |
| 1861786493 | Pain Relief Center | Clinic/Center | 903 South State Street, Jerseyville, IL 62052 | 2011-05-31 |
| 1902058845 | Ronald Lee Schroeder | Obstetrics & Gynecology | 1211 West Carpenter, Jerseyville, IL 62052 | 2008-10-22 |
| 1760696116 | Rebecca Elaine Alexander | Massage Therapist | 1301 S State St, Jerseyville, IL 62052 | 2007-05-09 |
| 1205950540 | Charles C Alexander | Chiropractor | 1301 S State, Jerseyville, IL 62052 | 2007-03-19 |
| 1902816358 | Kirk William Schultz | Chiropractor | 519 South State Street, Jerseyville, IL 62052 | 2006-08-08 |
| 1235119652 | Batool N Vali | Obstetrics & Gynecology | 1702 W. County Road, Jerseyville, IL 62052 | 2006-01-20 |
| 1649270729 | Jersey County Health Department | Public Health or Welfare | 1307 State Highway 109, Jerseyville, IL 62052 | 2005-07-29 |
| Find all providers in zip 62052 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881291 | Sarah Zeigler Olsen | Nurse Practitioner | 600 S Randall Rd Ste 220, Algonquin, IL 60102-5937 | 2020-11-02 |
| 1467051151 | Mallory Jo Brooks | Nurse Practitioner | 2306 E County Road 1800 N, Carthage, IL 62321-3101 | 2020-10-22 |
| 1508475294 | Diedra M Ahlert | Nurse Practitioner | 1320 Lexington Dr, Collinsville, IL 62234-4348 | 2020-07-28 |
| 1679182802 | Danielle L Shubert | Nurse Practitioner | 9423 Holy Cross Ln Ste 111, Breese, IL 62230-3510 | 2020-07-23 |
| 1154962900 | Janna Hoppe | Nurse Practitioner | 24600 W 127th St Ste 345, Plainfield, IL 60585-9507 | 2019-10-02 |
| 1841858529 | Katherine R Conkling | Nurse Practitioner | 4941 Benchmark Centre Dr Ste 100, Swansea, IL 62226-2038 | 2019-05-29 |
| 1942767280 | Danielle R Wetzel | Nurse Practitioner | 2040 Ogden Ave Ste 215, Aurora, IL 60504-7205 | 2019-02-22 |
| 1669937231 | Colleen Ann Larkin | Nurse Practitioner | 10939 S Troy St, Chicago, IL 60655-2211 | 2019-02-07 |
| 1568939684 | Katelyn Marie Reed | Nurse Practitioner | 415 N 9th St Ste 4w64, Springfield, IL 62702-5303 | 2018-10-26 |
| 1255813218 | Michelle Christine Bollinger | Nurse Practitioner | 415 N 9th St Ste 4w16, Springfield, IL 62702-5303 | 2018-09-05 |
| Find all providers with the same taxonomy | ||||
| City | JERSEYVILLE |
| Zip Code | 62052 |
Please comment or provide details below to improve the information on CARRIE H PURDY.
| 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.