PHILIP WILLIAM MACK (NPI# 1861476798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861476798 |
| Entity Type | Individual |
| Full Name | PHILIP WILLIAM MACK |
| Credential | MD |
| Practice Address |
516 Carew St Springfield MA 01104-2330 |
| Practice Telephone | 4137872047 |
| Practice Fax Number | 4137872054 |
| Mailing Telephone | 4137872047 |
| Mailing Fax Number | 4137872054 |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2013-10-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 208323 | MA | Allopathic & Osteopathic Physicians |
| N | 207XP3100X |
Orthopaedic Surgery Specialization: Pediatric Orthopaedic Surgery |
050085 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
516 CAREW ST |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01104-2330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770014821 | Maureen Theresa Nahorniak | Physical Therapist | 516 Carew St, Springfield, MA 01104-2330 | 2017-03-21 |
| 1831638253 | David Joseph Kreps | Physical Therapist | 516 Carew St, Springfield, MA 01104-2330 | 2017-02-17 |
| 1699222695 | Keri Garry | Nurse Practitioner | 516 Carew St, Springfield, MA 01104-2330 | 2016-09-07 |
| 1902208945 | Pediatric Orthotic and Prosthetic Services-northeast,llc | Prosthetic/Orthotic Supplier | 516 Carew St, Springfield, MA 01104-2330 | 2014-09-22 |
| 1154720027 | Rubini Pathy | Orthopaedic Surgery | 516 Carew St, Springfield, MA 01104-2330 | 2014-08-17 |
| 1285078444 | The Shriners' Hospital for Children | Orthopaedic Surgery | 516 Carew St, Springfield, MA 01104-2330 | 2013-04-18 |
| 1023360716 | Adam J Iwanski | Physician Assistant | 516 Carew St, Springfield, MA 01104-2330 | 2012-10-05 |
| 1942575147 | Ahmad Fouad Bayomy | Orthopaedic Surgery | 516 Carew St, Springfield, MA 01104 | 2012-03-20 |
| 1255633665 | Tammy L Sears-langevin | Nurse Practitioner | 516 Carew St, Springfield, MA 01104-2396 | 2010-11-18 |
| 1831304211 | Philip B Stoddard | Plastic Surgery | 516 Carew St, Shriners Hospital for Children, Springfield, MA 01104 | 2007-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346727567 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2155 Main Street, Suite 131/133, Springfield, MA 01104 | 2018-07-20 |
| 1508385618 | Demetrios Sotiropoulos | Physician Assistant | 175 Carew St Ste 250, Springfield, MA 01104 | 2017-09-11 |
| 1114382942 | Rosana Rivera-delgado | Psychologist | 4017 Liberty St, Springfield, MA 01104 | 2015-12-21 |
| 1417363516 | Springfield Family Pharmacy, Inc | Pharmacy | 175 Carew St, Suite 100, Springfield, MA 01104 | 2014-07-09 |
| 1437588837 | Ariam Ivette Pena | Counselor | 85 St. George Road, Springfield, MA 01104 | 2013-11-06 |
| 1891124293 | Ana E. Centeno | Counselor | 85 St. George Road., Springfield, MA 01104 | 2013-11-06 |
| 1275962003 | Swany Matos | Counselor | 2155 Main St., Springfield, MA 01104 | 2013-11-02 |
| 1184053910 | Claudia Eileen Quesada | Counselor | 2155 Main Street and St. George Road, The Gandara Center, Springfield, MA 01104 | 2013-11-02 |
| 1194023044 | Hungry Hill Family Practice | Clinic/Center | 776 Liberty Street, Hungry Hill Family Practice, Springfield, MA 01104 | 2011-03-02 |
| 1710115308 | Michael Allen Roche | Counselor | 332 Bernie Ave, Center for Human Development, Springfield, MA 01104 | 2009-06-23 |
| Find all providers in zip 01104 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104440049 | Elliot M Johns | Orthopaedic Surgery | 301 N 8th St Ste 3a158, Springfield, IL 62701-1085 | 2020-06-06 |
| 1740804764 | David Alan Forgas | Orthopaedic Surgery | 901 N 1st St # D252, Springfield, IL 62702-3759 | 2020-06-05 |
| 1063849719 | Effingham Hospital, Inc. | Orthopaedic Surgery | 459 Highway 119 S Ste A, Springfield, GA 31329-3021 | 2013-09-26 |
| 1851646566 | Kenneth David Illingworth | Orthopaedic Surgery | 301 N 8th St Pav 3a158, Springfield, IL 62794 | 2012-07-18 |
| 1760792329 | Lasante Inc | Orthopaedic Surgery | 4936 Laverna Road, Springfield, IL 62707-9797 | 2010-10-18 |
| 1902134638 | Optim Orthopedics, LLC | Orthopaedic Surgery | 459 Highway 119 South, Springfield, GA 31329 | 2009-11-18 |
| 1861630113 | Acustep Diabetic Foot Center, LLC | Orthopaedic Surgery | 2139 W Republic Rd, Springfield, MO 65807-5705 | 2009-01-24 |
| 1902066491 | Charles Joseph Ash | Orthopaedic Surgery | 3433 I S Campbell, Springfield, MO 65807 | 2008-06-10 |
| 1366616849 | Jennie Garver | Orthopaedic Surgery | 300 Birnie Ave Ste 301, Springfield, MA 01107 | 2008-04-16 |
| 1841487733 | Maplegate Rehab Inc. Dba Medical Associates | Orthopaedic Surgery | 181 State St, Springfield, MA 01103-1719 | 2007-09-25 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 01104 |
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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.