NICHOLE BROCKMEYER (NPI# 1922533157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922533157 |
| Entity Type | Individual |
| Full Name | NICHOLE BROCKMEYER |
| Practice Address |
2801 Mathers Rd Springfield IL 62711-7064 |
| Practice Telephone | 2177893600 |
| Practice Fax Number | 2177265867 |
| Mailing Telephone | (217) 789-3600 |
| Mailing Fax Number | 2177265867 |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2017-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 209016140 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2801 MATHERS RD |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62711-7064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023010782 | Poupak Ziaei | Internal Medicine | 2801 Mathers Rd, Springfield, IL 62711-7064 | 2005-08-12 |
| 1356710362 | Rajinder D Balasuriya | Internal Medicine | 2801 Mathers Rd, Springfield, IL 62711-7064 | 2015-09-20 |
| 1477825651 | Andrew Costerisan | Physician Assistant | 2801 Mathers Rd, Springfield, IL 62711-7064 | 2012-02-02 |
| 1225305881 | Kristin R. Buss | Physician Assistant | 2801 Mathers Rd, Springfield, IL 62711-7064 | 2011-11-28 |
| 1346357886 | Helen D Kwong | Internal Medicine | 2801 Mathers Rd, Springfield, IL 62711-7064 | 2006-08-23 |
| 1497765093 | Michael E Nenaber | Internal Medicine | 2801 Mathers Rd, Springfield, IL 62711-7064 | 2006-08-08 |
| 1689682718 | Minh H Nguyen | Family Medicine | 2801 Mathers Rd, Springfield, IL 62711-7064 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578057220 | Merissa Pryor | Social Worker | 4200 Conestoga Drive, Mbn 120, Springfield, IL 62711 | 2018-06-17 |
| 1255884623 | Dental Professionals of Illinois, P.C. | Dentist | 2740 Prairie Crossing Drive, Springfield, IL 62711 | 2016-08-02 |
| 1841682424 | Americare At Centennial Pointe Assisted Living LLC | Assisted Living Facility | 3440 Hedley Road, Springfield, IL 62711 | 2015-02-19 |
| 1306249248 | Schon Dental, LLC | Dentist | 2809 Mansion Road Suite D, Springfield, IL 62711 | 2014-10-07 |
| 1891105490 | John Weiss | Pharmacist | 4200 Conestoga Drive, Springfield, IL 62711 | 2014-05-05 |
| 1720350689 | Victor Harold Lary | Family Medicine | 3251 Spaulding Orchard Road, Springfield, IL 62711 | 2012-02-07 |
| 1902181795 | Amanda Rose Davis | Pharmacist | 2500 Koke Mill Rd, Springfield, IL 62711 | 2011-10-12 |
| 1316233703 | Karen Zerkle | Dentist | 2809 Mansion Rd, Suite D, Springfield, IL 62711 | 2011-06-23 |
| 1255520557 | Link Chiropractic LLC | Chiropractor | 7012 Kingsmill Ct, Springfield, IL 62711 | 2007-10-23 |
| 1669688230 | Victoria Lynn Driskill | Dentist | 4701 W. Wabash Ave, Springfield, IL 62711 | 2007-05-14 |
| Find all providers in zip 62711 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578178422 | Behishta Ishanzai | Nurse Practitioner | 7500 Geoint Dr, Springfield, VA 22150-7500 | 2020-09-08 |
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1255951331 | Bryndi Raye Shirley | Nurse Practitioner | 1636 S Glenstone Ave Ste 100, Springfield, MO 65804-1527 | 2020-04-20 |
| 1750900379 | Gemma Nicole D'angelo | Nurse Practitioner | 996 Stoneybrook Dr, Springfield, PA 19064-3829 | 2020-04-14 |
| 1629607882 | Melanie Herrin | Nurse Practitioner | 6230 Rolling Rd Ste J, Springfield, VA 22152-2326 | 2020-04-08 |
| 1871133520 | Deborah Ann Tully | Nurse Practitioner | 2 Medical Center Dr Ste 202, Springfield, MA 01107-1272 | 2020-01-10 |
| 1932759651 | Amanda Couchon | Nurse Practitioner | 759 Chestnut St Radiology Department, Springfield, MA 01199-0001 | 2019-09-14 |
| 1760947410 | Andrea K Leger | Nurse Practitioner | 300 Birnie Ave Ste 102, Springfield, MA 01107-1375 | 2019-02-07 |
| 1417421579 | Stephanie M Yeager | Nurse Practitioner | 3850 S National Ave Ste 700, Springfield, MO 65807-5292 | 2019-01-11 |
| 1215415799 | Bree Schmulbach | Nurse Practitioner | Bsb Room 20, Springfield, IL 62703 | 2018-08-06 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62711 |
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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.