Individual provider Active NPI

Lindsey Nicole Newby, PA-C

  • Physician Assistant
  • Champaign, IL
National Provider Identifier
1679809248
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085003556 Issued in IL
Practice address
1801 Windsor Rd
Champaign, IL 61822-6217
Phone
(217) 366-6104
Fax
(217) 366-6106
NPI assigned
Nov 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085003556 IL Primary

Addresses

Primary practice location

1801 Windsor Rd
Champaign, IL 61822-6217

Mailing address

101 W University Ave
Champaign, IL 61820-3909
Phone (217) 366-1326

Other names 1

  • Lindsey Nicole Holcomb Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091221000316 IL Practitioner - Physician Assistant 6305986431 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians
Anderson Medical Group LLCGroup PAC ID 5193792018, 136 clinicians

Practice addresses (Care Compare)

1711 W Hwy 50
O Fallon, IL 62269-1681
Phone (618) 206-5076

2090 Vadalabene Dr
Maryville, IL 62062-5841
Phone (618) 288-5430

2524 N Illinois St
Swansea, IL 62226-2353
Phone (618) 212-3144

4211 N Cicero Ave
Chicago, IL 60641-1651
Phone (773) 794-1000

515 Belt Line Rd
Collinsville, IL 62234-4411
Phone (618) 381-9041

Hospital & facility affiliations

  • Anderson Hospital Hospital, Maryville, IL, CCN 140289

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Medical Group, LLC CurrentSince Dec 1, 2025 Accepting new patients

Locations

1103 Belt Line Rd
#B
Collinsville, IL 62234
Phone (618) 344-0090

6810 State Route 162
Ste 215
Maryville, IL 62062
Phone (618) 391-6405

2090 Vadalabene Dr
Maryville, IL 62062
Phone (618) 288-5430

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1679809248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203909",
            "telephone_number": "217-366-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 WINDSOR RD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618226217",
            "telephone_number": "217-366-6104",
            "fax_number": "217-366-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBY",
        "first_name": "LINDSEY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-02",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSEY",
            "last_name": "HOLCOMB",
            "middle_name": "NICOLE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.