DUSTIN KERN (NPI# 1750517488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750517488 |
| Entity Type | Individual |
| Full Name | DUSTIN KERN |
| Practice Address |
8600 N State Route 91 Suite 250 Peoria IL 61615-9541 |
| Practice Telephone | 3096925394 |
| Practice Fax Number | 3096922272 |
| Mailing Telephone | 3096925394 |
| Mailing Fax Number | 3096922272 |
| Enumeration Date | 2009-06-09 |
| Last Update Date | 2013-10-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 041-339058 | IL | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE | PENDING | 01 |
| Street Address |
8600 N STATE ROUTE 91 SUITE 250 |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-9541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073501359 | Jeremy L Krock | Anesthesiology | 8600 N State Route 91, Suite 250, Peoria, IL 61615-9541 | 2005-10-11 |
| 1861948044 | Monica L Dunn | Nurse Practitioner | 8600 N State Route 91, Peoria, IL 61615-9541 | 2016-08-29 |
| 1013369149 | Brittany N Hemmele | Nurse Practitioner | 8600 N State Route 91, Peoria, IL 61615-9541 | 2016-07-13 |
| 1497107296 | Kathryn A Swain-abraham | Nurse Practitioner | 8600 N State Route 91, Peoria, IL 61615-9541 | 2016-07-06 |
| 1538537444 | Kristin M Burns | Advanced Practice Midwife | 8600 N State Route 91, Suite 330, Peoria, IL 61615-9541 | 2015-09-09 |
| 1669840575 | Teverbaugh Croland and Mueller Ob/gyn and Associates, S.c. | Advanced Practice Midwife | 8600 N State Route 91, Suite 330, Peoria, IL 61615-9541 | 2015-09-09 |
| 1518356419 | Cody Dykes | Nurse Anesthetist, Certified Registered | 8600 N State Route 91, Suite 250, Peoria, IL 61615-9541 | 2015-01-15 |
| 1093119661 | Megan M Cunningham | Physician Assistant | 8600 N State Route 91, Peoria, IL 61615-9541 | 2014-10-10 |
| 1285037929 | Lauren M Petoskey | Physician Assistant | 8600 N State Route 91, Peoria, IL 61615-9541 | 2014-10-08 |
| 1396144846 | Jessica B Young | Physician Assistant | 8600 N State Route 91, Peoria, IL 61615-9541 | 2014-08-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
| 1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
| 1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
| 1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821609751 | Amanda Ferreira | Student in an Organized Health Care Education/Training Program | 7421 W Shangri La Rd, Peoria, AZ 85345-5811 | 2020-08-13 |
| 1699396838 | Ashif Khaled Molla | Student in an Organized Health Care Education/Training Program | Osf St Francis Medical Center 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2020-04-28 |
| 1437779063 | Mena Henien | Student in an Organized Health Care Education/Training Program | 530 Ne Glen Oak Ave Bldg 5676, Peoria, IL 61637-0001 | 2020-04-23 |
| 1306465893 | Sarath Kumar Jaganathan Jaishankar | Student in an Organized Health Care Education/Training Program | 530 Ne Glenn Oak Avenue, Peoria, IL 61637-0001 | 2020-04-14 |
| 1952920522 | Phu Si Huynh | Student in an Organized Health Care Education/Training Program | 331 Fulton St Apt 302, Peoria, IL 61602-1436 | 2020-04-13 |
| 1730736604 | Gabriela C Isenia | Student in an Organized Health Care Education/Training Program | 9031 W Tonopah Dr, Peoria, AZ 85382-6445 | 2019-08-24 |
| 1831751643 | Noreen Khan | Student in an Organized Health Care Education/Training Program | 1501 W Coneflower Dr Apt 2212, Peoria, IL 61615-7465 | 2019-07-01 |
| 1174184527 | Manisha Tharoor | Student in an Organized Health Care Education/Training Program | 530 N.e Glen Oak Ave, Peoria, IL 61637 | 2019-06-26 |
| 1609436724 | Sriviji Senthil Kumaran | Student in an Organized Health Care Education/Training Program | 530. N.e Glen Oak Ave., Peoria, IL 61637 | 2019-06-20 |
| 1780240929 | Abuzar Ali Asif | Student in an Organized Health Care Education/Training Program | 530 N. E. Glen Oak Ave., Peoria, IL 61637 | 2019-05-14 |
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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.