Amanda P Lively (NPI# 1982064622, PAC ID# 2365724184) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1982064622 |
| PAC ID by PECOS | 2365724184 |
| Professional Enrollment ID | I20181204002477 |
| Full Name | Amanda P Lively |
| Organization Legal Name | HSHS MEDICAL GROUP INC |
| Address |
300 Sattley St Rochester IL 62563-9241 |
| Phone Number | 2177891403 |
| Gender | F |
| Graduation Year | 2015 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 5092857821 |
| Number of Group Practice Members | 376 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140053 | ST JOHNS HOSPITAL |
| 140148 | MEMORIAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 300 Sattley St, Rochester, IL 62563-9241 | 2177891403 | HSHS MEDICAL GROUP INC |
| Organization Legal Name | HSHS MEDICAL GROUP INC |
| Physicians | 372 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Deborah L Pulliam | Nurse Practitioner | Hshs Medical Group Inc | 4965 E Lost Bridge Rd, Decatur, IL 62521-5139 |
| Rajinder D Balasuriya | Internal Medicine | Hshs Medical Group Inc | 2801 Mathers Rd, Springfield, IL 62711-7064 |
| Justin Bradley Hill | Family Medicine | Hshs Medical Group Inc | 1116 Hartman Ln, Shiloh, IL 62221-8014 |
| Sahar Yazdani | Family Medicine | Hshs Medical Group Inc | 125 E Plummer Blvd, Chatham, IL 62629-8047 |
| Paula Kay Hubbard | Nurse Practitioner | Hshs Medical Group Inc | 1836 S Macarthur Blvd, Springfield, IL 62704-4030 |
| Melissa Kay Edwards | Nurse Practitioner | Hshs Medical Group Inc | 2965 N Main St E, Hshs Medical Group Internal Medicine N Decatur, Decatur, IL 62526-4392 |
| Judy M Tonry | Nurse Practitioner | Hshs Medical Group Inc | 1118 W Legacy Pointe Dr, Springfield, IL 62711-6444 |
| Mohammed Iyoob Mohammed Ilyas | General Surgery | Hshs Medical Group Inc | 904 Medical Park Dr, Effingham, IL 62401-2193 |
| Imtiaz H Bangash | Internal Medicine | Hshs Medical Group Inc | 1800 E Lake Shore Dr, Decatur, IL 62521-3810 |
| Krystal Gilb | Nurse Practitioner | Hshs Medical Group Inc | 2401 S Ctr St, Maryville, IL 62062-5401 |
| Street Address |
300 SATTLEY ST |
| City | ROCHESTER |
| State | IL |
| Zip | 62563-9241 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mary E Ely | Nurse Practitioner | Hshs Medical Group Inc | 300 Sattley St, Rochester, IL 62563-9241 |
| Wendi L Campbell | Nurse Practitioner | Hshs Medical Group Inc | 300 Sattley St, Rochester, IL 62563-9241 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bruce E Semans | Pathology | 101 E Main St, Rochester, IL 62563-9507 |
| City | ROCHESTER |
| Zip Code | 62563 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | ROCHESTER + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Amanda P Lively.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.