DR. JORDAN S YOUNGERMAN (NPI# 1992724553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992724553 |
Entity Type | Individual |
Full Name | DR. JORDAN S YOUNGERMAN |
Credential | M.D. |
Practice Address |
1 Memorial Dr Suite 110 Decatur IL 62526-6303 |
Mailing Address |
2300 N Edward St Gsbll Decatur IL 62526-4163 |
Practice Telephone | 2174242442 |
Practice Fax Number | 2174249431 |
Mailing Telephone | 2178762857 |
Mailing Fax Number | 2178762874 |
Enumeration Date | 2006-07-18 |
Last Update Date | 2014-09-04 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 174400000X | Specialist | 036084067 | IL | Other Service Providers |
Street Address |
1 MEMORIAL DR SUITE 110 |
City | DECATUR |
State | IL |
Zip Code | 62526-6303 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891058566 | Mamatha Moodalagiriaiah | Obstetrics & Gynecology | 1 Memorial Dr, Suite 300, Decatur, IL 62526-6303 | 2012-06-19 |
1124327598 | Women's Health Care Specialists of Decatur, LLC | Obstetrics & Gynecology | 1 Memorial Dr, Physicians Plaza East, Suite 216, Decatur, IL 62526-6303 | 2011-03-23 |
1437465325 | Carle Health Care Incorporated | Durable Medical Equipment & Medical Supplies | 1 Memorial Dr, Physicians Plaza East, Suite 300, Decatur, IL 62526-6303 | 2010-08-30 |
1255647962 | Kathy J Schafer | Nurse Practitioner | 1 Memorial Dr, Suite 300, Decatur, IL 62526-6303 | 2010-08-19 |
1659531903 | Pierre Michael Johnson | Obstetrics & Gynecology | 1 Memorial Dr, Suite 300, Decatur, IL 62526-6303 | 2008-06-11 |
1306026224 | Julie Marie Preston | Physician Assistant | 1 Memorial Dr, Physcians Plaza East Ste 110, Decatur, IL 62526-6303 | 2007-11-08 |
1396897526 | Decatur Obgyn Associates, LLC | Obstetrics & Gynecology | 1 Memorial Dr, Suite 300, Decatur, IL 62526-6303 | 2007-01-17 |
1629139266 | Andrea Tirpak | Nurse Practitioner | 1 Memorial Dr, Suite 300, Decatur, IL 62526-6303 | 2006-12-13 |
1558470690 | Gregory L Totel | Internal Medicine | 1 Memorial Dr, Suite 201, Decatur, IL 62526-6303 | 2006-08-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
Find all providers in zip 62526 |
Taxonomy Code | 174400000X |
Grouping | Other Service Providers |
Classification | Specialist |
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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1033660345 | Sabra Services LLC | Specialist | 726 County Road 3250, Decatur, TX 76234-4857 | 2016-10-21 |
1154874758 | Erica Nicole West | Specialist | 3446 Newberry Trl, Decatur, GA 30034-3248 | 2016-07-31 |
1639552649 | Supreme Healthcare Ob/gyn LLC | Specialist | 5536 Flat Shoals Pkwy, Suite A, Decatur, GA 30034-5408 | 2015-07-08 |
1427474766 | Russell Clinding | Specialist | 5036 Snapfinger Woods Dr Ste 217, Decatur, GA 30035-4047 | 2014-03-11 |
1598013831 | Total Health Pain Center | Specialist | 4150 Snapfinger Way, Suite 102, Decatur, GA 30035-2711 | 2012-08-16 |
1841420510 | Deborah Tawil | Specialist | 118 Barry St, Decatur, GA 30030-3465 | 2009-07-16 |
1396973665 | Wanda Denise Nelson | Specialist | 3275 Creekway Ln, Decatur, GA 30034-4909 | 2009-06-25 |
1053588731 | David Douglas Shepard | Specialist | 2675 N Decatur Rd Ste 200, Decatur, GA 30033-6132 | 2008-05-13 |
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.