LEWIS MEMORIAL CHRISTIAN VILLAGE (NPI# 1154638021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1154638021 |
Entity Type | Organization |
Organization Name | LEWIS MEMORIAL CHRISTIAN VILLAGE |
Practice Address |
3400 W Washington St Springfield IL 62711-7917 |
Practice Telephone | 2177879600 |
Mailing Telephone | 2177879600 |
Enumeration Date | 2010-09-13 |
Last Update Date | 2010-09-13 |
Authorized Official Name | LAVERNE BROOMFIELD (COTA) |
Authorized Official Telephone | 2177879600 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 305R00000X | Preferred Provider Organization | 057003241 | IL | Managed Care Organizations |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780991612 | Lewis Memorial Christian Village | Skilled Nursing Facility | 3400 W Washington St, Springfield, IL 62711-7917 | 2010-09-14 |
1417264391 | Lewis Memorial Christian Village | Preferred Provider Organization | 3400 W Washington St, Springfield, IL 62711-7917 | 2010-09-13 |
1063654937 | Lewis Memorial Christian Village | Durable Medical Equipment & Medical Supplies | 3400 W Washington St, Springfield, IL 62711-7917 | 2009-03-24 |
1578589974 | Lewis Memorial Christian Village | Skilled Nursing Facility | 3400 W Washington St, Springfield, IL 62711-7917 | 2006-07-15 |
Street Address |
3400 W WASHINGTON ST |
City | SPRINGFIELD |
State | IL |
Zip Code | 62711-7917 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932160009 | David M Schneller | Physical Therapist | 3400 W Washington St, Springfield, IL 62711-7917 | 2006-03-29 |
1407337538 | Reagan Worth | Occupational Therapist | 3400 W Washington St, Springfield, IL 62711-7917 | 2018-08-27 |
1386124915 | Sara J Cox | Physical Therapist | 3400 W Washington St, Springfield, IL 62711-7917 | 2018-08-14 |
1003302274 | Barbara Lynn Notz | Physical Therapist | 3400 W Washington St, Springfield, IL 62711-7917 | 2018-07-10 |
1790150530 | Samantha Susan Sitki | Occupational Therapist | 3400 W Washington St, Springfield, IL 62711-7917 | 2015-12-04 |
1821407883 | Charle Bordeau | Speech-Language Pathologist | 3400 W Washington St, Springfield, IL 62711-7917 | 2014-08-04 |
1235579673 | Amruta Pradhan | Physical Therapist | 3400 W Washington St, Springfield, IL 62711-7917 | 2013-06-30 |
1780991612 | Lewis Memorial Christian Village | Skilled Nursing Facility | 3400 W Washington St, Springfield, IL 62711-7917 | 2010-09-14 |
1417264391 | Lewis Memorial Christian Village | Preferred Provider Organization | 3400 W Washington St, Springfield, IL 62711-7917 | 2010-09-13 |
1891001319 | Sarah H Hennemann | Physical Therapist | 3400 W Washington St, Springfield, IL 62711-7917 | 2010-08-21 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578057220 | Merissa Pryor | Social Worker | 4200 Conestoga Drive, Mbn 120, Springfield, IL 62711 | 2018-06-17 |
1255884623 | Dental Professionals of Illinois, P.C. | Dentist | 2740 Prairie Crossing Drive, Springfield, IL 62711 | 2016-08-02 |
1841682424 | Americare At Centennial Pointe Assisted Living LLC | Assisted Living Facility | 3440 Hedley Road, Springfield, IL 62711 | 2015-02-19 |
1306249248 | Schon Dental, LLC | Dentist | 2809 Mansion Road Suite D, Springfield, IL 62711 | 2014-10-07 |
1891105490 | John Weiss | Pharmacist | 4200 Conestoga Drive, Springfield, IL 62711 | 2014-05-05 |
1720350689 | Victor Harold Lary | Family Medicine | 3251 Spaulding Orchard Road, Springfield, IL 62711 | 2012-02-07 |
1902181795 | Amanda Rose Davis | Pharmacist | 2500 Koke Mill Rd, Springfield, IL 62711 | 2011-10-12 |
1316233703 | Karen Zerkle | Dentist | 2809 Mansion Rd, Suite D, Springfield, IL 62711 | 2011-06-23 |
1255520557 | Link Chiropractic LLC | Chiropractor | 7012 Kingsmill Ct, Springfield, IL 62711 | 2007-10-23 |
1669688230 | Victoria Lynn Driskill | Dentist | 4701 W. Wabash Ave, Springfield, IL 62711 | 2007-05-14 |
Find all providers in zip 62711 |
Taxonomy Code | 305R00000X |
Grouping | Managed Care Organizations |
Classification | Preferred Provider Organization |
A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
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1316369622 | Consolidated Health Plan | Preferred Provider Organization | 2077 Roosevelt Ave, Springfield, MA 01104-1657 | 2014-01-07 |
1316162456 | Springfield Orthodontic Associates, Pllc | Preferred Provider Organization | 6564 Loisdale Ct Ste 325, Springfield, VA 22150-1831 | 2007-04-16 |
1487007845 | Robert T. Dewar, Dds., PC | Preferred Provider Organization | 1704 N Robberson Ave, Springfield, MO 65803-2845 | 2016-07-20 |
1043622368 | Innovative Dental | Preferred Provider Organization | 3424 S Culpepper Ct, Springfield, MO 65804-3755 | 2014-05-21 |
1215372347 | Community Health Centers of Lane County | Preferred Provider Organization | 2073 Olympic St, Springfield, OR 97477-3413 | 2013-05-02 |
1417264391 | Lewis Memorial Christian Village | Preferred Provider Organization | 3400 W Washington St, Springfield, IL 62711-7917 | 2010-09-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972129625 | Shawnte Jenkins-alexander, Ed.d. Lcpc. Ltd | Preferred Provider Organization | 155 N Michigan Ave Ste 328, Chicago, IL 60601-7591 | 2020-06-18 |
1134686439 | Qualsight LLC | Preferred Provider Organization | 9525 Bryn Mawr Ave Ste 725, Rosemont, IL 60018-5262 | 2019-02-23 |
1053876367 | Hope Network Foundation | Preferred Provider Organization | 332 S Michigan Ave Ste 10850, Chicago, IL 60604-4434 | 2019-01-31 |
1801336441 | Emily Edelman Psychotherapy, An Illinois Corporation | Preferred Provider Organization | 2100 S Marshall Blvd, Apt 804, Chicago, IL 60623-3679 | 2017-03-01 |
1821549163 | Family Dental Practice | Preferred Provider Organization | 9709 Milwaukee Ave, Glenview, IL 60025-4567 | 2016-10-21 |
1548613094 | Shaunna R Repa | Preferred Provider Organization | 2231 Dawson Ln, Algonquin, IL 60102-5983 | 2016-07-20 |
1417308081 | Mother Dearest | Preferred Provider Organization | 14214 Woodlawn Ave, Dolton, IL 60419-1316 | 2016-06-24 |
1992154991 | Demoulin Family Chiropractic, Ltd. | Preferred Provider Organization | 11danada Square East, Wheaton, IL 60189-8484 | 2016-06-09 |
1790131936 | Plainfield Pediatric Dental Care PC | Preferred Provider Organization | 13621 S. Rt 59, Unit 101, Plainfield, IL 60544 | 2016-05-06 |
1417310335 | The Metro Mentorship Initiative | Preferred Provider Organization | 1828 N Lowell Ave, Chicago, IL 60639-4818 | 2016-03-29 |
Find all providers with the same taxonomy |
City | SPRINGFIELD |
Zip Code | 62711 |
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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.