JULIA RACKLEY PERRY MEMORIAL HOSPITAL (NPI# 1033649967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033649967 |
Entity Type | Organization |
Organization Name | JULIA RACKLEY PERRY MEMORIAL HOSPITAL |
Other Organization Name | PERRY MEMORIAL WALNUT CLINIC |
Practice Address |
105 N Main St Ste 1 Walnut IL 61376-9707 |
Mailing Address |
530 Park Ave E Princeton IL 61356-3901 |
Practice Telephone | 8153792020 |
Practice Fax Number | 8153792018 |
Mailing Telephone | 8158764419 |
Mailing Fax Number | 8158764455 |
Enumeration Date | 2017-06-13 |
Last Update Date | 2020-06-15 |
Authorized Official Name | JEAN WELTE (MEDICAL STAFF SERVICES COORDINATOR) |
Authorized Official Telephone | 8158762293 |
Is Organization Subpart | Y |
Parent Organization Name | JULIA RACKLEY PERRY MEMORIAL HOSPITAL |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
0001883 | IL | Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Perry Memorial Walnut Clinic | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932610110 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 530 Park Ave E Fl 3, Princeton, IL 61356-3901 | 2017-10-16 |
1578083051 | Julia Rackley Perry Memorial Hospital | Surgery | 530 Park Ave E Ste 205, Princeton, IL 61356-3902 | 2017-06-26 |
1629598602 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 327 Edward St, Henry, IL 61537-1539 | 2017-06-21 |
1124021308 | Julia Rackley Perry Memorial Hospital | General Acute Care Hospital | 530 Park Ave E, Princeton, IL 61356-3901 | 2005-05-23 |
1134695422 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 327 Edward St, Henry, IL 61537-1539 | 2018-10-15 |
1043786338 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 105 N Main St Ste 1, Walnut, IL 61376-9707 | 2018-10-15 |
1952877243 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 530 Park Ave E Ste 303, Princeton, IL 61356-3903 | 2018-10-15 |
1699229823 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 2128 N Main St, Princeton, IL 61356-9728 | 2016-08-04 |
1326408204 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 2128 N Main St, Princeton, IL 61356-9728 | 2016-03-04 |
1578922050 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 535 Park Ave E, Princeton, IL 61356-3901 | 2016-02-12 |
Street Address |
105 N MAIN ST STE 1 |
City | WALNUT |
State | IL |
Zip Code | 61376-9707 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043786338 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 105 N Main St Ste 1, Walnut, IL 61376-9707 | 2018-10-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588707095 | Dean A. Hulsing PC | Chiropractor | 405 W. North Street, Walnut, IL 61376 | 2007-02-14 |
1083764880 | Walnut Fire Department Inc | Ambulance | 115 Liberty Street, Walnut, IL 61376 | 2007-01-12 |
1730108002 | Dean A Hulsing | Chiropractor | 405 W North Street, Walnut, IL 61376 | 2006-07-18 |
1407806953 | Linda L Grant | Nurse Practitioner | 131 East Jackson Street, Walnut, IL 61376 | 2006-05-12 |
1467640292 | Carolyn Jean Gale | Physician Assistant | 101 N Main St, Walnut, IL 61376 | 2007-10-05 |
1467687525 | Walnut Fire Protection District | Ambulance | 122 E Jackson Street, Walnut, IL 61376-0523 | 2009-05-19 |
1508069717 | Daniel B Fuertges | Dentist | 101 N Main St, Walnut, IL 61376-0624 | 2007-06-06 |
1861483307 | Heritage Manor - Walnut, LLC | Skilled Nursing Facility | 308 S 2nd St, Walnut, IL 61376-9363 | 2005-11-03 |
1275005654 | Aspen Quadri | Occupational Therapy Assistant | 308 S 2nd St, Walnut, IL 61376-9364 | 2018-12-21 |
1700351814 | Katie C Edwards | Occupational Therapy Assistant | 308 S 2nd St, Walnut, IL 61376-9364 | 2018-10-05 |
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Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
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1013438704 | Emily Byars | Clinic/Center | 1111 Greenfield Circle, Geneva, IL 60134 | 2017-07-03 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.