MR. JUSTIN WILLIAM KIERBS (NPI# 1841579026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841579026 |
| Entity Type | Individual |
| Full Name | MR. JUSTIN WILLIAM KIERBS |
| Credential | ACNP-BC |
| Practice Address |
1750 E Lake Shore Dr Suite 200 Decatur IL 62521-3803 |
| Practice Telephone | 2174286300 |
| Practice Fax Number | 2174286322 |
| Mailing Telephone | 2174286300 |
| Mailing Fax Number | 2174286322 |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2015-05-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
209008969 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1750 E LAKE SHORE DR SUITE 200 |
| City | DECATUR |
| State | IL |
| Zip Code | 62521-3803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285621516 | Jon Fredrick Petersen | Family Medicine | 1750 E Lake Shore Dr, Decatur, IL 62521-3803 | 2005-10-03 |
| 1265947451 | Antoniannette Pate | Nurse Practitioner | 1750 E Lake Shore Dr, Decatur, IL 62521-3803 | 2017-12-10 |
| 1578093225 | Jason Blanchetti | Nurse Practitioner | 1750 E Lake Shore Dr, Decatur, IL 62521-3803 | 2017-06-15 |
| 1992182331 | Alyson Webb | Nurse Practitioner | 1750 E Lake Shore Dr, Ste 310, Decatur, IL 62521-3803 | 2015-05-06 |
| 1932527017 | Adills Moosa | Preventive Medicine | 1750 E Lake Shore Dr, Decatur, IL 62521-3803 | 2014-04-04 |
| 1194012260 | Nikesh Lath | Surgery | 1750 E Lake Shore Dr, Decatur, IL 62521-3803 | 2011-07-08 |
| 1922319839 | Chinelo C Echeazu | Obstetrics & Gynecology | 1750 E Lake Shore Dr, Suite 110, Decatur, IL 62521 | 2010-06-24 |
| 1215267596 | Vikram S Kotwal | Internal Medicine | 1750 E Lake Shore Dr, Suite 310, Decatur, IL 62521-3803 | 2010-01-08 |
| 1396073813 | Mohammed A. Rahman | Neurological Surgery | 1750 E Lake Shore Dr, 110, Decatur, IL 62521-3803 | 2009-11-20 |
| 1750617007 | Randi Rigsby | Nurse Practitioner | 1750 E Lake Shore Dr, Suite 100, Decatur, IL 62521-3803 | 2009-10-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927988 | Caleb David Braasch | Pharmacist | 1818 South Airport Rd, Decatur, IL 62521 | 2020-09-16 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1154848034 | Zack Shaw | Physical Therapist | 4855-57 East 36, Decatur, IL 62521 | 2017-08-23 |
| 1790032852 | Prashant Morolia | Family Medicine | 4775 E Maryland St, Decatur, IL 62521 | 2012-08-08 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1104133099 | Suzette Marie Shafer | Occupational Therapy Assistant | 1790 S. Fairview Ave., Decatur, IL 62521 | 2010-09-13 |
| 1467784090 | Community Health Improvement Center | Clinic/Center | 1221 East Condit Street, Decatur, IL 62521 | 2010-02-08 |
| 1982839056 | Kelly Clark Dds PC | Dentist | 3737 Us Rt 36 E, Decatur, IL 62521 | 2009-05-19 |
| Find all providers in zip 62521 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134759137 | Brittany N Eischeid | Nurse Practitioner | 1502 S Fm 51 Ste B, Decatur, TX 76234-2476 | 2020-01-19 |
| 1992276497 | Laura Beth Miller | Nurse Practitioner | 302 W Hay St Ste 110, Decatur, IL 62526-4167 | 2018-12-09 |
| 1417445206 | Kamla Gonzales | Nurse Practitioner | 5146 Miller Woods Trl, Decatur, GA 30035 | 2018-04-26 |
| 1235520321 | Catherine Kelsey Kinslow | Nurse Practitioner | 2406 Hwy 31, Decatur, AL 35603-1504 | 2015-02-10 |
| 1912093816 | Cara A Gravlin | Nurse Practitioner | 102 W Kenwood Ave Lowr Level, Decatur, IL 62526-4368 | 2006-10-05 |
| 1811595085 | Glenn Andrew Thomas | Nurse Practitioner | 2665 N Decatur Rd Ste 430, Decatur, GA 30033-6145 | 2020-10-11 |
| 1861019697 | Esther Miranda Hambrick | Nurse Practitioner | 1310 14th Ave Se, Decatur, AL 35601-4347 | 2020-06-27 |
| 1740818814 | Valerie Lynn Rouse Beliard | Nurse Practitioner | 2701 N Decatur Rd, Decatur, GA 30033-5918 | 2020-04-01 |
| 1689238909 | Sara K Pollock | Nurse Practitioner | 2701 N Decatur Rd, Decatur, GA 30033-5918 | 2019-04-23 |
| 1255890703 | Rachel Elizabeth Branton | Nurse Practitioner | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2019-03-14 |
| Find all providers in DECATUR | ||||
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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.