Organization Active NPI

Joanne a Michaelson MD

  • Anesthesiology Physician
  • Rock Island, IL
National Provider Identifier
1497734099
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
JOANNE A MICHAELSON MD
Practice address
2701 17TH St
Rock Island, IL 61201-5351
Phone
(309) 779-5000
NPI assigned
Jan 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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

Authorized official

Name
Joanne A Michaelson, MDNPI 1679552269
Title
President
Phone
(309) 762-9711

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X IL Primary

Addresses

Primary practice location

2701 17TH St
Rock Island, IL 61201-5351

Mailing address

PO Box 689
Lake Forest, IL 60045-0689
Phone (847) 615-2200

Other identifiers 2

IdentifierTypeStateIssuer
0560748MedicaidIA
1560748MedicaidIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1497734099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600450689",
            "telephone_number": "847-615-2200",
            "fax_number": "847-615-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015351",
            "telephone_number": "309-779-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOANNE A MICHAELSON MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "MICHAELSON",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-762-9711",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0560748",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1560748",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; 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.