Active NPI
Gaynell Sue Ladislas, APN
- Nurse Practitioner
- Oblong, IL
National Provider Identifier
1982688263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209003339
- Practice address
- 104 N Garfield St
Oblong, IL 62449-1426 - Phone
- (618) 592-3119
- Fax
- (618) 592-3875
- NPI assigned
- Dec 1, 2005
- Last updated
- Jan 10, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209003339 | IL | Primary |
Addresses
Primary practice location
104 N Garfield St
Oblong, IL 62449-1426
Mailing address
104 N Garfield St
Oblong, IL 62449-1426
Phone (618) 592-3119
Other names 1
- Mrs. Gaynell Sue Ladislas
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209003339 | IL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crawford Hospital District | Past | Accepting new patients | |
| Midwest Medical Management, P.C. | Past | Accepting new patients | |
| Union Hospital, Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba CMH Specialty Clinic-Newton
- Urology Physician
- Newton, IL
- NPI 1265309405
-
- Emergency Medicine Physician
- Terre Haute, IN
- NPI 1417996430
-
dba Union Hospital Clinton
- Medicare Defined Swing Bed Hospital Unit
- Clinton, IN
- NPI 1487652319
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326153600000",
"number": "1982688263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 N GARFIELD ST",
"city": "OBLONG",
"state": "IL",
"postal_code": "624491426",
"telephone_number": "618-592-3119",
"fax_number": "618-592-3875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 N GARFIELD ST",
"city": "OBLONG",
"state": "IL",
"postal_code": "624491426",
"telephone_number": "618-592-3119",
"fax_number": "618-592-3875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LADISLAS",
"first_name": "GAYNELL",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-01",
"last_updated": "2012-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209003339",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "GAYNELL",
"last_name": "LADISLAS",
"middle_name": "SUE",
"prefix": "MRS.",
"credential": "FNP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Oblong, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.