Maryville Womens Center SSR PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

MARYVILLE WOMENS CENTER SSR PC

Practice address

2016 Vadalabene Dr
Suite B
Maryville, IL 62062-6901

Phone

(618) 288-2970

Fax

(618) 288-3572

NPI assigned

Feb 5, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kimberly N Sanford, M.D.

Title

Owner

Phone

(618) 288-2970

Specialties & licenses 4

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454630400000",
    "number": "1427416494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 VADALABENE DR",
            "address_2": "SUITE B",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620626901",
            "telephone_number": "618-288-2970",
            "fax_number": "618-288-3572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 VADALABENE DR",
            "address_2": "SUITE B",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620626901",
            "telephone_number": "618-288-2970",
            "fax_number": "618-288-3572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYVILLE WOMENS CENTER SSR PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-05",
        "last_updated": "2016-02-05",
        "status": "A",
        "authorized_official_last_name": "SANFORD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-288-2970",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryville Internal Medicine, LTD
• Maryville Medical Services, LLC
• Maryville Pharmacy Inc
• Maryville Physicians Services Inc
• Maryville Radiology Group, LTD
• Kara L McGarrahan, OT
• Robert C. McKee, MD
• Laura E. McKinzie, NP
• Katrina McNair-Smith, MS,CCC-A
• Anna McNamara, PT, DPT

• Obstetrics & Gynecology Physician in Maryville, IL
• Providers in Maryville, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.