Med Plus Physical Medicine LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

248000193 Issued in IL

Legal business name

MED PLUS PHYSICAL MEDICINE LLC

Practice address

20 Professional Park Dr
Suite a
Maryville, IL 62062-5830

Phone

(618) 288-5044

Fax

(618) 288-9472

NPI assigned

Aug 2, 2011

Last updated

Aug 2, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew W Bretz, DC

Title

Owner

Phone

(618) 594-3671

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312243200000",
    "number": "1730467135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18209 EULA MAE PKWY",
            "city": "CARLYLE",
            "state": "IL",
            "postal_code": "622316407",
            "telephone_number": "618-594-3671",
            "fax_number": "618-594-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROFESSIONAL PARK DR",
            "address_2": "SUITE A",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625830",
            "telephone_number": "618-288-5044",
            "fax_number": "618-288-9472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED PLUS PHYSICAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-02",
        "last_updated": "2011-08-02",
        "status": "A",
        "authorized_official_last_name": "BRETZ",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-594-3671",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "248000193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert C. McKee, MD
• Laura E. McKinzie, NP
• Katrina McNair-Smith, MS,CCC-A
• Anna McNamara, PT, DPT
• McPherson Medical & Diagnostic LLC (American Medical Missouri)
• Holly Mellenthin
• Jaime Renee Mendoza, PMHNP
• Mercy Clinic Specialists Services-Illinois LLC
• Mercy Clinic Surgical Specialists-Illinois LLC
• Heather Rae Merkle, LCPC

• General Practice Physician in Maryville, IL
• Providers in Maryville, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; 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.