PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION (NPI# 1174580831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174580831 |
| Entity Type | Organization |
| Organization Name | PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION |
| Other Organization Name | PASSAVANT AREA HOSPITAL |
| Practice Address |
1600 W Walnut St Jacksonville IL 62650 |
| Mailing Address |
1600 W Walnut St Jacksonville IL 62650-9980 |
| Practice Telephone | 2172459541 |
| Practice Fax Number | 2174798781 |
| Mailing Telephone | 2172459541 |
| Mailing Fax Number | 2174798781 |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2018-07-18 |
| Authorized Official Name | MR. HARRY M SCHMIDT (PRESIDENT & CEO) |
| Authorized Official Telephone | 2172459541 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEMORIAL HEALTH SYSTEMS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 0001792 | IL | Hospitals |
| Other Name | Type Code |
|---|---|
| Passavant Area Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760994040 | Passavant Memorial Area Hospital Association | Family Medicine | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2017-10-26 |
| 1366813404 | Passavant Memorial Area Hospital Association | Psychiatric Unit | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2015-10-15 |
| 1558530956 | Passavant Memorial Area Hospital Association | General Acute Care Hospital | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2008-02-29 |
| 1629115050 | Passavant Memorial Area Hospital Association | Skilled Nursing Facility | 1600 W Walnut St, Jacksonville, IL 62650 | 2007-02-01 |
| 1689780520 | Passavant Memorial Area Hospital Association | Dietitian, Registered | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2006-08-22 |
| 1497861330 | Passavant Memorial Area Hospital Association | General Acute Care Hospital | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2006-08-22 |
| Street Address |
1600 W WALNUT ST |
| City | JACKSONVILLE |
| State | IL |
| Zip Code | 62650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609873249 | Charles Milton Sheaff | Surgery | 1600 W Walnut St, East Wing 2nd Floor, Jacksonville, IL 62650-1136 | 2005-06-28 |
| 1528690799 | Holly Diane Pennell | Nurse Practitioner | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2020-02-06 |
| 1669004081 | Elizabeth Ann Johnson | Nurse Practitioner | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2020-02-05 |
| 1164053526 | Kayla Christine Vickers | Physical Therapist | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2020-02-03 |
| 1366912040 | Kelsi Lynn Dobson | Social Worker | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2018-11-26 |
| 1114402518 | Michelle Lee Geiss | Nurse Practitioner | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2018-10-02 |
| 1134606858 | Matthew Pulley | Nurse Practitioner | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2018-07-25 |
| 1760994040 | Passavant Memorial Area Hospital Association | Family Medicine | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2017-10-26 |
| 1871002238 | Courtney Howell | Social Worker | 1600 W Walnut St, Jacksonville, IL 62650-1136 | 2017-09-28 |
| 1831639194 | Carrie Elizabeth Janus | Nurse Practitioner | 1600 W Walnut St, The Center for Psychiatric Health, Jacksonville, IL 62650-1136 | 2017-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134768708 | Stephanie Lee Mabus | Occupational Therapy Assistant | 873 Gorve St, Jacksonville, IL 62650 | 2019-12-31 |
| 1285281071 | Sharshon Pharmacy Inc | Pharmacy | 154 W Morton Ave, Jacksonville, IL 62650 | 2019-08-26 |
| 1992275499 | Brittany Ruth Helmich | Counselor | 340 W. State St., Jacksonville, IL 62650 | 2018-11-28 |
| 1811391782 | Rodney E. Overstreet | Hearing Instrument Specialist | 1521 W. Walnut, Jacksonville, IL 62650 | 2014-10-21 |
| 1407979818 | Jan Ala | Speech-Language Pathologist | 1111 W Morton, Speechworks, Jacksonville, IL 62650 | 2007-04-09 |
| 1083787592 | Eldon G Barrowes Dds & Assoc PC | Dentist | 1515 West Walnut, Bldg #3, Jacksonville, IL 62650 | 2006-11-15 |
| 1194895979 | Joseph J Kozma | Internal Medicine | 1440 West Walnut, Jacksonville, IL 62650 | 2006-11-08 |
| 1740350529 | Susan Weller | Dentist | 1614 West Lafayette Avenue, Jackson, IL 62650 | 2006-11-08 |
| 1659467793 | Shawn M Fry | Family Medicine | 610 N. Westgate, Jacksonville, IL 62650 | 2006-10-05 |
| 1518050061 | Ward Richard Dunseth II | Nurse Anesthetist, Certified Registered | 1400 W Walnut, Jacksonville, IL 62650 | 2006-10-02 |
| Find all providers in zip 62650 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528683257 | Gainesville Vamc | General Acute Care Hospital | 2080 Child St Bldg 200h, Jacksonville, FL 32214-5005 | 2020-06-09 |
| 1922487974 | Shemaka James | General Acute Care Hospital | 5202 Wabash Blvd, Jacksonville, FL 32254-1366 | 2015-05-22 |
| 1962893149 | Michelle Porter | General Acute Care Hospital | 402 Stagecoach Dr, Jacksonville, NC 28546-8663 | 2015-02-10 |
| 1811246390 | St. Vincent's Healthcare | General Acute Care Hospital | 3 Shircliff Way Ste 714, Jacksonville, FL 32204-4786 | 2012-08-30 |
| 1255570974 | Svila Skin Solutions | General Acute Care Hospital | 1936 San Marco Blvd, Jacksonville, FL 32207-3286 | 2009-02-19 |
| 1760644009 | Walter Ruday Jr. | General Acute Care Hospital | 2748 University Blvd W, Jacksonville, FL 32217-2123 | 2008-06-27 |
| 1386801116 | Abdolreza Mohammadian | General Acute Care Hospital | 1536 N.jefferson Street, Va Outpatient Clinic, Jacksonville, FL 32209-0000 | 2008-05-20 |
| 1861451114 | Allegiance Hospital of North Little Rock, LLC | General Acute Care Hospital | 1400 Braden St., Jacksonville, AR 72076 | 2006-03-23 |
| 1730697350 | Jacksonville Hospital LLC | General Acute Care Hospital | 501 S Ragsdale St, Jacksonville, TX 75766-2434 | 2018-01-17 |
| 1144735069 | Brynn Marr Hospital - Navy Resource Sharing | General Acute Care Hospital | 192 Village Dr, Jacksonville, NC 28546-7238 | 2017-12-14 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 62650 |
Please comment or provide details below to improve the information on PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION.
| 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.