Erin P. O'Brien, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

175 S Main St
Canton, IL 61520-2670

Phone

(309) 647-0201

Fax

(309) 649-5302

NPI assigned

Jan 30, 2007

Sex

Female

Sole proprietor

No

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.

• Graham Services Corporation

  • Family Medicine Physician
  • Canton, IL
  • NPI 1942315197
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

• Erin P. Simpson Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 27, 2007.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198713600000",
    "number": "1881730331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 S MAIN ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202670",
            "telephone_number": "309-647-0201",
            "fax_number": "309-649-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 S MAIN ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202670",
            "telephone_number": "309-647-0201",
            "fax_number": "309-649-5302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "ERIN",
        "middle_name": "P.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "0062839",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02922981",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "200397",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI CLINIC NUMBER",
            "identifier": "1942315197",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CG5172",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "SIMPSON",
            "middle_name": "P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Madison Mustread, PHARMD
• Lacey Neal
• Alicia Nelson, M.S. CCC-SLP
• North Central Behavioral Health Systems, Inc.
• North Central Behavioral Health Systems, Inc.
• Brent D Parry, DPM
• Patterson House, Inc.
• Petersen Health Care
• Petersen Health Care, Inc.
• Petersen Health Junction, LLC

• All providers in Canton, IL
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.