CENTRAL COUNTIES HEALTH CENTERS, INC. (NPI# 1205282936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205282936 |
| Entity Type | Organization |
| Organization Name | CENTRAL COUNTIES HEALTH CENTERS, INC. |
| Practice Address |
1440 W Walnut St Suite 2 Jacksonville IL 62650-1143 |
| Mailing Address |
2239 E Cook St Springfield IL 62703-1944 |
| Practice Telephone | 2177882300 |
| Practice Fax Number | 2177882342 |
| Mailing Telephone | 2177882300 |
| Mailing Fax Number | 2177882342 |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2016-05-19 |
| Authorized Official Name | CINDY KAVANAGH (ACCOUNTANT) |
| Authorized Official Telephone | 2177882300 |
| Is Organization Subpart | Y |
| Parent Organization Name | CENTRAL COUNTIES HEALTH CENTERS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 122300000X | Dentist | Dental Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861911893 | Central Counties Health Centers, Inc. | Clinic/Center | 5220 6th Street Frontage Rd E Ste 2400, Springfield, IL 62703-5761 | 2017-09-11 |
| 1346791167 | Central Counties Health Centers, Inc. | Family Medicine | 1023 E Washington St, Springfield, IL 62703-1047 | 2016-10-17 |
| 1669520177 | Central Counties Health Centers, Inc. | Internal Medicine | 430 N 5th St, St John's Breadline, Springfield, IL 62702-5202 | 2007-01-08 |
| 1992853428 | Central Counties Health Centers, Inc. | Family Medicine | 221 N 11th St, Hch - Salvation Army - 6th St., Springfield, IL 62703-1003 | 2007-01-08 |
| 1235287756 | Central Counties Health Centers, Inc. | Internal Medicine | 1100 E Adams St, Hch - Contact Ministries, Springfield, IL 62703-1030 | 2007-01-08 |
| 1245759273 | Central Counties Health Centers, Inc. | Clinic/Center | 120 N 11th St, Springfield, IL 62703-1002 | 2017-09-11 |
| 1225588387 | Central Counties Health Centers, Inc. | Dentist | 800 E Carpenter St, Springfield, IL 62702-5324 | 2016-10-12 |
| 1013467646 | Central Counties Health Centers, Inc. | Dentist | 1141 N Cheney St, Taylorville, IL 62568-2741 | 2016-10-06 |
| 1578611000 | Central Counties Health Centers, Inc. | Family Medicine | 221 N 11th St, Hch - Salvation Army 11th, Springfield, IL 62703-1003 | 2007-01-08 |
| 1861480709 | Central Counties Health Centers, Inc. | Nurse Practitioner | 2239 E Cook St, Springfield, IL 62703-1944 | 2005-10-13 |
| Street Address |
1440 W WALNUT ST SUITE 2 |
| City | JACKSONVILLE |
| State | IL |
| Zip Code | 62650-1143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770576829 | Peter Damon Russotto | Podiatrist | 1440 W Walnut St, #5, Jacksonville, IL 62650-1143 | 2005-08-24 |
| 1972023117 | Ethan Duewer | Dentist | 1440 W Walnut St, Jacksonville, IL 62650-1143 | 2017-06-20 |
| 1114322286 | Jersey Community Hospital | Pediatrics | 1440 W Walnut St, Suite 2a, Jacksonville, IL 62650-1143 | 2014-10-30 |
| 1891034294 | Illini Medical Associates, Sc | Pediatrics | 1440 W Walnut St, Ste 2a, Jacksonville, IL 62650-1143 | 2013-02-05 |
| 1558480418 | Physical Therapists Clinic,ltd | Clinic/Center | 1440 W Walnut St, Suite 2, Jacksonville, IL 62650-1143 | 2007-03-29 |
| 1083769475 | Physical Therapists Clinic, Ltd | Physical Therapist | 1440 W Walnut St, Suite2, Jacksonville, IL 62650-1143 | 2007-01-24 |
| 1174608533 | Donald Robert Beckett Jr. | Dentist | 1440 W Walnut St, Suite 2, Jacksonville, IL 62650 | 2006-10-26 |
| 1336179712 | Amy Jo Blanford | Physical Therapist | 1440 W Walnut St, Building #2, Jacksonville, IL 62650-1143 | 2006-07-03 |
| 1245203439 | Linda V Stevens-schilsky | Pediatrics | 1440 W Walnut St, Jacksonville, IL 62650 | 2006-02-09 |
| 1043299803 | Abby G Henry | Physical Therapist | 1440 W Walnut St, #2, Jacksonville, IL 62650-1143 | 2006-01-11 |
| 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 | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518469527 | Special Health Resources for Texas, Incorporated | Clinic/Center | 1011 College Street, Jacksonville, TX 75766-3307 | 2018-03-06 |
| 1982069795 | Agape Community Health Center, Inc. | Clinic/Center | 5316 N Pearl St, Jacksonville, FL 32208-5119 | 2015-12-21 |
| 1497010425 | Fl Department of Health | Clinic/Center | 1736 University Blvd S, Jacksonville, FL 32216-8929 | 2012-07-05 |
| 1578892485 | Grandmary's House | Clinic/Center | 4828 Evanston Rd, Jacksonville, FL 32208 | 2009-12-24 |
| 1326668351 | Agape Community Health Center, Inc | Clinic/Center | 6024 Merrill Rd, Jacksonville, FL 32277-3427 | 2020-04-20 |
| 1376178814 | Agape Community Health Center, Inc | Clinic/Center | 1680 Dunn Ave Ste 35, Jacksonville, FL 32218-4744 | 2020-03-05 |
| 1760963516 | Arcare | Clinic/Center | 1400 Braden St Ste 1, Jacksonville, AR 72076-3721 | 2018-08-28 |
| 1649628009 | Board of Trustees of Southern Illinois University | Clinic/Center | 345 W State St, Jacksonville, IL 62650-1879 | 2016-05-26 |
| 1578928826 | Agape Community Health Center, Inc. | Clinic/Center | 5460 Blanding Blvd, Jacksonville, FL 32244-1957 | 2015-12-30 |
| 1245695774 | Agape Community Health Center, Inc | Clinic/Center | 3900 University Blvd S Ste 2, Jacksonville, FL 32216-4331 | 2015-12-29 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 62650 |
Please comment or provide details below to improve the information on CENTRAL COUNTIES HEALTH CENTERS, INC..
| 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.