Anderson Medical Group, Llc - Medicare Primary Care in Maryville, IL

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Anderson Medical Group, Llc is a medicare enrolled primary clinic (Clinic/center - Multi-specialty) in Maryville, Illinois. The current practice location for Anderson Medical Group, Llc is 6810 State Route 162, Suite 215, Maryville, Illinois. For appointments, you can reach them via phone at (618) 288-5711. The mailing address for Anderson Medical Group, Llc is 6810 State Route 162, Suite 215, Maryville, Illinois and phone number is (618) 288-5711.

Anderson Medical Group, Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1700807716. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (618) 288-5711.

Contact Information

Anderson Medical Group, Llc
6810 State Route 162
Suite 215
Maryville
IL 62062-8501
(618) 288-5711
(618) 288-4088

Map and Direction


Primary Care Clinic Profile

Full NameAnderson Medical Group, Llc
SpecialityClinic/Center
Location6810 State Route 162, Maryville, Illinois
Authorized Official Name and PositionMichael Marshall (CFO)
Authorized Official Contact6183916402
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Anderson Medical Group, Llc
6810 State Route 162
Suite 215
Maryville
IL 62062-8501

Ph: (618) 288-5711		Anderson Medical Group, Llc
6810 State Route 162
Suite 215
Maryville
IL 62062-8501

Ph: (618) 288-5711

NPI Details:

NPI Number1700807716
Provider Enumeration Date07/22/2006
Last Update Date02/11/2020

Medicare PECOS Information:

Medicare PECOS PAC ID5193792018
Medicare Enrollment IDO20040910001137

Medical Identifiers

Medical identifiers for Anderson Medical Group, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1700807716NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QM1300XClinic/center - Multi-specialty (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Anderson Medical Group, Llc acts as a billing entity for following providers:
Provider NameDennis M Hurford
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1497708259
PECOS PAC ID: 5294633376
Enrollment ID: I20031229000145
Provider NameBarbara Joy Foner
Provider TypePractitioner - Critical Care (intensivists)
Provider IdentifiersNPI Number: 1437141090
PECOS PAC ID: 7113820804
Enrollment ID: I20040129001022
Provider NameBrett R Grebing
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1447252978
PECOS PAC ID: 9537054424
Enrollment ID: I20040219000197
Provider NamePatrice L Staten
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1154481364
PECOS PAC ID: 7214835941
Enrollment ID: I20040414001315
Provider NameRodney L Lupardus
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1710946280
PECOS PAC ID: 4183610876
Enrollment ID: I20040420001310
Provider NameJason E Barnett
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1295728988
PECOS PAC ID: 7911980032
Enrollment ID: I20040610000387
Provider NameSophia Y Rostovtseva
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1427042381
PECOS PAC ID: 8224013743
Enrollment ID: I20040621000252
Provider NameKristen L Ferguson
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1750308227
PECOS PAC ID: 6608843263
Enrollment ID: I20040927000763
Provider NameCharles A Lane
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1164581468
PECOS PAC ID: 4284696329
Enrollment ID: I20041101000325
Provider NameScott A Wong
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1275604498
PECOS PAC ID: 5991767055
Enrollment ID: I20041101000430
Provider NameKyle P Shepperson
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1407831704
PECOS PAC ID: 5395708911
Enrollment ID: I20041104001093
Provider NamePaul Jerome Scherer
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1881679181
PECOS PAC ID: 7315914439
Enrollment ID: I20041104001175
Provider NameTimothy Joseph Penn
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1124003439
PECOS PAC ID: 5597732610
Enrollment ID: I20041104001189
Provider NamePeter J Anderson
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1548245848
PECOS PAC ID: 8123095247
Enrollment ID: I20041108000385
Provider NameSajjan K Nemani
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1649220542
PECOS PAC ID: 2668437195
Enrollment ID: I20041124000183
Provider NameDean F Schueler
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1417916099
PECOS PAC ID: 2961468616
Enrollment ID: I20041206000146
Provider NameRiaz A Naseer
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1245345537
PECOS PAC ID: 0547227043
Enrollment ID: I20041222000222
Provider NameMichael E Mandis
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1821065764
PECOS PAC ID: 8820047699
Enrollment ID: I20050119000426
Provider NameMohammad A Zaman
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1346350196
PECOS PAC ID: 6002701471
Enrollment ID: I20051108000936
Provider NameEric D Lopatin
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1356381271
PECOS PAC ID: 5597787838
Enrollment ID: I20051229000562
Provider NameRobert C Mckee
Provider TypePractitioner - Plastic And Reconstructive Surgery
Provider IdentifiersNPI Number: 1528142312
PECOS PAC ID: 5799799979
Enrollment ID: I20060126000468
Provider NameRodney L Greeling
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1700960572
PECOS PAC ID: 4587678149
Enrollment ID: I20060202000729
Provider NameDavid B Yablonsky
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1780665901
PECOS PAC ID: 6800808676
Enrollment ID: I20060616000056
Provider NameRafe M Heng
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1477560126
PECOS PAC ID: 4082718325
Enrollment ID: I20070327000370
Provider NameWilliam Thom
Provider TypePractitioner - Anesthesiology
Provider IdentifiersNPI Number: 1225015456
PECOS PAC ID: 2466480736
Enrollment ID: I20070912000451
Provider NameDavid E Johnson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477742047
PECOS PAC ID: 8921195736
Enrollment ID: I20071025000520
Provider NameTibor C Kopjas
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1952332918
PECOS PAC ID: 5698863975
Enrollment ID: I20071120000554
Provider NameHenry E Purcell
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1467530410
PECOS PAC ID: 3375450257
Enrollment ID: I20071215000117
Provider NameLarry Curtis Dobbs
Provider TypePractitioner - Otolaryngology
Provider IdentifiersNPI Number: 1881628931
PECOS PAC ID: 4587754361
Enrollment ID: I20071217000584
Provider NamePaulo S Bicalho
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1487606810
PECOS PAC ID: 8921188178
Enrollment ID: I20071231000323
Provider NameLaura S Bird
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1295720993
PECOS PAC ID: 6709786072
Enrollment ID: I20080707000215
Provider NameJessica L Sheehan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1467654772
PECOS PAC ID: 7315038890
Enrollment ID: I20080709000672
Provider NameEdmundo Alejandro Rodriguez-frias
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1912117912
PECOS PAC ID: 0941363881
Enrollment ID: I20090120000469
Provider NameSriraj Kanungo
Provider TypePractitioner - Nephrology
Provider IdentifiersNPI Number: 1548355621
PECOS PAC ID: 0547281776
Enrollment ID: I20090204000135
Provider NameJeffrey T Fierstein
Provider TypePractitioner - Otolaryngology
Provider IdentifiersNPI Number: 1740259043
PECOS PAC ID: 8628074010
Enrollment ID: I20090306000482
Provider NamePatrick S Zimmermann
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1194749218
PECOS PAC ID: 9032143938
Enrollment ID: I20100109000131
Provider NameMichelle P Mulligan
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1194721936
PECOS PAC ID: 2961546775
Enrollment ID: I20100217000583
Provider NameMichael E Mulligan
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1417953316
PECOS PAC ID: 9133296247
Enrollment ID: I20100222000602
Provider NameGeorge Tzelepis
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1497769558
PECOS PAC ID: 9436156924
Enrollment ID: I20110210000290
Provider NameDanielle Bogue
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1295062537
PECOS PAC ID: 2466632930
Enrollment ID: I20110216000107
Provider NameJoann M Wilson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1073762308
PECOS PAC ID: 1456532258
Enrollment ID: I20110228000508
Provider NameMark S Fedder
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1922009943
PECOS PAC ID: 1153503602
Enrollment ID: I20110304000782
Provider NameRonald John Gould
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1811042708
PECOS PAC ID: 1759472129
Enrollment ID: I20120209000141
Provider NamePei C Chung
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1669609988
PECOS PAC ID: 7810042827
Enrollment ID: I20120316000723
Provider NameKaren L Ridenour
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720347933
PECOS PAC ID: 5092971440
Enrollment ID: I20120730000466
Provider NameKelley R Campbell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245590074
PECOS PAC ID: 8729234695
Enrollment ID: I20120808000480
Provider NameRichard H Wikiera
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1093962896
PECOS PAC ID: 2163664194
Enrollment ID: I20130805000139
Provider NameBillie L Vincent
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1639508039
PECOS PAC ID: 7911134812
Enrollment ID: I20131223000806
Provider NameJessica Lynn Walker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1639476369
PECOS PAC ID: 1759512213
Enrollment ID: I20140326000663
Provider NameMatthew Cary
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619233525
PECOS PAC ID: 8325201296
Enrollment ID: I20140505001172
Provider NameAmanda L Patterson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1518362946
PECOS PAC ID: 8921324377
Enrollment ID: I20150303001360
Provider NameChristy T Weiss
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1437549367
PECOS PAC ID: 7618294281
Enrollment ID: I20150318001952
Provider NameAlyssa R Loepker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992194401
PECOS PAC ID: 1557688868
Enrollment ID: I20150326000212
Provider NameTara A Topper
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649660200
PECOS PAC ID: 7618297482
Enrollment ID: I20150519000024
Provider NameAnn Altgilbers
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1447638887
PECOS PAC ID: 1658682885
Enrollment ID: I20150615001910
Provider NameEmily A Yakel
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215302781
PECOS PAC ID: 5496058638
Enrollment ID: I20160122000563
Provider NameRandi Hummel
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386005635
PECOS PAC ID: 3072811009
Enrollment ID: I20160407001356
Provider NameRuth Holley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396107587
PECOS PAC ID: 9931499944
Enrollment ID: I20160603000714
Provider NameErin M Wright
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1922307115
PECOS PAC ID: 4688981012
Enrollment ID: I20161108000640
Provider NameAngela Marie Kage
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881145159
PECOS PAC ID: 4385923408
Enrollment ID: I20161114000895
Provider NameAngela Marie Lytle
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1770025868
PECOS PAC ID: 8325328727
Enrollment ID: I20161130001883
Provider NameJanae M Korte
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396288502
PECOS PAC ID: 5395029300
Enrollment ID: I20170310000610
Provider NameAlyssa M Martz
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1043757867
PECOS PAC ID: 5597040121
Enrollment ID: I20170322002764
Provider NameDanielle N Fries
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1093256612
PECOS PAC ID: 9739465667
Enrollment ID: I20170417000001
Provider NameSrimannarayana Marella
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1861745218
PECOS PAC ID: 1951535129
Enrollment ID: I20170511001222
Provider NameBeth A Denmon
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1609304401
PECOS PAC ID: 9537439187
Enrollment ID: I20170714001370
Provider NameMichael J Walter
Provider TypePractitioner - Critical Care (intensivists)
Provider IdentifiersNPI Number: 1629096359
PECOS PAC ID: 6305871401
Enrollment ID: I20170824000003
Provider NameMegan Mihelcic
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1205263589
PECOS PAC ID: 1658509500
Enrollment ID: I20170828004286
Provider NameKayla B Wuebbels
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1417474511
PECOS PAC ID: 3375819386
Enrollment ID: I20171018003384
Provider NameEddie L Paulk
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1003813601
PECOS PAC ID: 4284618463
Enrollment ID: I20171129000036
Provider NameKelly A Martin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619123353
PECOS PAC ID: 4284992025
Enrollment ID: I20171227001341
Provider NameMegan Springman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740793389
PECOS PAC ID: 7618236217
Enrollment ID: I20180104000973
Provider NameCayla Denise Wester
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1699274001
PECOS PAC ID: 9931461225
Enrollment ID: I20180327000113
Provider NameSaulat Mushtaq
Provider TypePractitioner - Rheumatology
Provider IdentifiersNPI Number: 1518080605
PECOS PAC ID: 2668666298
Enrollment ID: I20180330000014
Provider NameTara S Hilmes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1275064768
PECOS PAC ID: 1951665827
Enrollment ID: I20180430001593
Provider NameKatie Marie Krueger
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1922515220
PECOS PAC ID: 9133484447
Enrollment ID: I20180606003446
Provider NameJustin Bradley Hill
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1477797645
PECOS PAC ID: 4587971486
Enrollment ID: I20180814001728
Provider NameKelsy B Wasmuth
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336659838
PECOS PAC ID: 4587917158
Enrollment ID: I20181029001609
Provider NameKaleena D Galletta
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740787795
PECOS PAC ID: 3375808959
Enrollment ID: I20190401001061
Provider NameLindsey Michelle Senci
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649771544
PECOS PAC ID: 9537401534
Enrollment ID: I20190423000919
Provider NameRyan Parker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912478231
PECOS PAC ID: 5698008233
Enrollment ID: I20190613000270
Provider NameGina Marie Vernace
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1427408392
PECOS PAC ID: 4284991613
Enrollment ID: I20190627003075
Provider NameSujata Sitaula
Provider TypePractitioner - Endocrinology
Provider IdentifiersNPI Number: 1548678261
PECOS PAC ID: 1759670938
Enrollment ID: I20190710000891
Provider NameKristen James
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1770977100
PECOS PAC ID: 6406183664
Enrollment ID: I20190809002203
Provider NameJamie M Schneider
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245791847
PECOS PAC ID: 0244569705
Enrollment ID: I20190909001301
Provider NameBryson Thomas Whalen
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1255727301
PECOS PAC ID: 9436468428
Enrollment ID: I20191011000682
Provider NameLarissa L Jones
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730508433
PECOS PAC ID: 7416171319
Enrollment ID: I20191028001680
Provider NamePatricia Teschke
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1790045417
PECOS PAC ID: 0446550909
Enrollment ID: I20200320000348
Provider NameNeill M Wright
Provider TypePractitioner - Neurosurgery
Provider IdentifiersNPI Number: 1770500209
PECOS PAC ID: 8224186432
Enrollment ID: I20200514000715
Provider NameJenny M Daniels
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346783230
PECOS PAC ID: 1456638048
Enrollment ID: I20200623000225
Provider NameJoel Franco
Provider TypePractitioner - Otolaryngology
Provider IdentifiersNPI Number: 1891108452
PECOS PAC ID: 9931401361
Enrollment ID: I20200717003011
Provider NameTonya Ann Bosaw
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1821600693
PECOS PAC ID: 2264842376
Enrollment ID: I20201030001900
Provider NameTara Marie White
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619561594
PECOS PAC ID: 7719393396
Enrollment ID: I20210305000231
Provider NameJacob Wengert
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689097768
PECOS PAC ID: 9537391792
Enrollment ID: I20210623001834
Provider NameStephen J Johans
Provider TypePractitioner - Neurosurgery
Provider IdentifiersNPI Number: 1013273580
PECOS PAC ID: 7012219454
Enrollment ID: I20210820002725
Provider NameSarah J Fouke
Provider TypePractitioner - Neurosurgery
Provider IdentifiersNPI Number: 1154433712
PECOS PAC ID: 3476551409
Enrollment ID: I20210825001012
Provider NameJacob William Matsil
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1427537521
PECOS PAC ID: 3274882097
Enrollment ID: I20210916002606
Provider NameBrendan M Fong
Provider TypePractitioner - Neurosurgery
Provider IdentifiersNPI Number: 1245670504
PECOS PAC ID: 2860621885
Enrollment ID: I20211005003090
Provider NameTina A Winter
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1922676675
PECOS PAC ID: 0941699896
Enrollment ID: I20211115001037
Provider NameKatie Marie Albrecht
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528735149
PECOS PAC ID: 6002207370
Enrollment ID: I20211221000544
Provider NameElizabeth Ann Dawson
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1437505062
PECOS PAC ID: 8022302504
Enrollment ID: I20211230001123
Provider NameScott H Purvines
Provider TypePractitioner - Neurosurgery
Provider IdentifiersNPI Number: 1669436739
PECOS PAC ID: 9537190152
Enrollment ID: I20220208001525
Provider NameMichael N Polinsky
Provider TypePractitioner - Neurosurgery
Provider IdentifiersNPI Number: 1134183205
PECOS PAC ID: 7810927324
Enrollment ID: I20220209001629
Provider NameJeremy Cole Hollingsead
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1376000232
PECOS PAC ID: 5597005017
Enrollment ID: I20220314001515
Provider NameAndrew S Youkilis
Provider TypePractitioner - Neurosurgery
Provider IdentifiersNPI Number: 1740244813
PECOS PAC ID: 4284664780
Enrollment ID: I20220318000926
Provider NameSarah Saller Travers
Provider TypePractitioner - Neurosurgery
Provider IdentifiersNPI Number: 1699193748
PECOS PAC ID: 6406258391
Enrollment ID: I20220524000946
Provider NameJoshua Dwaine Lentz
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1134781412
PECOS PAC ID: 6103205679
Enrollment ID: I20220614002485
Provider NameSrishti Sharma
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1053843052
PECOS PAC ID: 2567731532
Enrollment ID: I20220629003658
Provider NameHa Thuy Hatley
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1437718384
PECOS PAC ID: 3870829062
Enrollment ID: I20220705000452
Provider NameLaurie Sparr
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1447766621
PECOS PAC ID: 8022342104
Enrollment ID: I20220720002613
Provider NameSrikanth Nadella
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1740599109
PECOS PAC ID: 9537396635
Enrollment ID: I20220907001768
Provider NameMelissa Armstead
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326599911
PECOS PAC ID: 5294114773
Enrollment ID: I20221208001755
Provider NamePaige Cosmas
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689388175
PECOS PAC ID: 6709257967
Enrollment ID: I20230125003499
Provider NameShelby Smiley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326755430
PECOS PAC ID: 7911378195
Enrollment ID: I20230413002404
Provider NameNellie Britton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538863808
PECOS PAC ID: 8224493226
Enrollment ID: I20230426002205
Provider NameBrenon Abernathie
Provider TypePractitioner - Plastic And Reconstructive Surgery
Provider IdentifiersNPI Number: 1497916977
PECOS PAC ID: 7214152099
Enrollment ID: I20230512001380
Provider NameMichael J Reiter
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1285051482
PECOS PAC ID: 7719200682
Enrollment ID: I20230828002401
Provider NameBeth Blankley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366191355
PECOS PAC ID: 2769869437
Enrollment ID: I20230927002555
Provider NameStephanie M Johnson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1437936549
PECOS PAC ID: 0446603112
Enrollment ID: I20240129004478

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Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 6800 State Route 162, Maryville, IL 62062
Phone: 618-288-5711    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.