SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP (NPI# 1245260645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245260645 |
| Entity Type | Organization |
| Organization Name | SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP |
| Other Organization Name | SHAWNEE HEALTH CARE, MURPHYSBORO |
| Practice Address |
7 South Hospital Drive Murphysboro IL 62966-3333 |
| Mailing Address |
Po Box 577 109 California Street Carterville IL 62918-0577 |
| Practice Telephone | 6186873418 |
| Practice Fax Number | 6186871859 |
| Mailing Telephone | 6189858221 |
| Mailing Fax Number | 6189856860 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2016-12-23 |
| Authorized Official Name | PATSY JENSEN (C.E.O.) |
| Authorized Official Telephone | 6189858221 |
| Is Organization Subpart | Y |
| Parent Organization Name | SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 10032052 | 01 |
| Other Name | Type Code |
|---|---|
| Shawnee Health Care, Murphysboro | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053878967 | Shawnee Health Service and Development Corp | Clinic/Center | 1025 N Wall St Rm 102, Carbondale, IL 62901-1737 | 2019-02-27 |
| 1699232512 | Shawnee Health Service and Development Corp | Clinic/Center | 801 S Lewis Ln Rm 153, Carbondale, IL 62901-3408 | 2019-02-27 |
| 1487111639 | Shawnee Health Service and Development Corp | Clinic/Center | 121 N Parrish Ln Rm 123, Carbondale, IL 62901-2024 | 2019-02-25 |
| 1841757242 | Shawnee Health Service and Development Corp | Clinic/Center | 1150 E Grand Ave Rm 127, Carbondale, IL 62901-3422 | 2019-02-22 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1356677058 | Shawnee Health Service and Development Corp | Dentist | 3115 Williamson County Pkwy, Marion, IL 62959-5235 | 2009-10-30 |
| 1639295314 | Shawnee Health Service and Development Corp | Social Worker | 109 California St, Carterville, IL 62918-0577 | 2007-03-22 |
| 1326079245 | Shawnee Health Service and Development Corp | Clinic/Center | 1301 E Walnut St Rm J120, Carbondale, IL 62901-5004 | 2006-07-06 |
| 1881624161 | Shawnee Health Service and Development Corp | Clinic/Center | 1700 Wildcat Dr Ste A, Marion, IL 62959-1513 | 2006-07-03 |
| 1902447196 | Shawnee Health Service and Development Corp | Clinic/Center | 101 S Wall St, Carbondale, IL 62901-3021 | 2019-09-30 |
| Street Address |
7 SOUTH HOSPITAL DRIVE |
| City | MURPHYSBORO |
| State | IL |
| Zip Code | 62966-3333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760426316 | Todd Smith | Family Medicine | 7 South Hospital Drive, Murphysboro, IL 62966-3333 | 2006-06-15 |
| 1689819435 | Cheryl Ellis | Nurse Practitioner | 7 South Hospital Drive, Murphysboro, IL 62966-3333 | 2008-12-09 |
| 1306869557 | Jeffrey Ripperda | Family Medicine | 7 South Hospital Drive, Murphysboro, IL 62966-3333 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093272999 | Lifenet, Inc. | Ambulance | 430 N Airport Rd, Murphysboro, IL 62966 | 2019-02-27 |
| 1538678354 | Anita Tallegien Daneshdoost | Physical Therapist | 1725 Shomaker Drive, Murphysboro, IL 62966 | 2017-09-25 |
| 1295281558 | Alternatives Counseling Inc. | Community/Behavioral Health | 1400 N Wood Road, Murphysboro, IL 62966 | 2016-08-28 |
| 1962855833 | Andrea Maren Whipple | Counselor | 617 Walnut St, Murphysboro, IL 62966 | 2016-07-15 |
| 1730544180 | Lasharon Smith | Non-emergency Medical Transport (VAN) | 37 Nins Lane, Murphysboro, WI 62966 | 2015-12-29 |
| 1710241328 | Kati K Rush | Podiatrist | 19 E Shawnee Dr Ste 3, Murphysboro, IL 62966 | 2012-06-28 |
| 1386709418 | Hoai P Nguyen | Dentist | 1116 Locust Street, Murphysboro, IL 62966 | 2006-12-27 |
| 1154416576 | Hayley Autumn Hood | Occupational Therapist | 6 East Shawnee, Murphysboro, IL 62966 | 2006-10-03 |
| 1356435135 | Southern Illinois Hospital Services | General Acute Care Hospital | 2 South Hospital Drive, Murphysboro, IL 62966 | 2006-10-03 |
| 1699879825 | Stephen Craig Mills | Chiropractor | 1010 N 14th St, Murphysboro, IL 62966 | 2006-09-08 |
| Find all providers in zip 62966 | ||||
| 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 |
|---|---|---|---|---|
| 1417567108 | Pillars Community Health | Clinic/Center | 15w458 91st St, Burr Ridge, IL 60527-6379 | 2020-08-06 |
| 1932724390 | Friend Family Health Center, Inc | Clinic/Center | 7355 S Jeffery Blvd, Chicago, IL 60649-3121 | 2020-06-11 |
| 1871117937 | Primecare Community Health Inc | Clinic/Center | 1431 N Western Ave Ste 101, Chicago, IL 60622-7712 | 2020-06-04 |
| 1639791569 | Community Health Partnership of Illinois | Clinic/Center | 201 W Kenyon Rd Bldg D, Champaign, IL 61820-7892 | 2020-05-14 |
| 1407482219 | Access Community Health Network | Clinic/Center | 6020 W Diversey Ave Bldg West, Chicago, IL 60639-1108 | 2020-03-13 |
| 1235769704 | Greater Elgin Family Care Center | Clinic/Center | 451 N Mclean Blvd, Elgin, IL 60123-3239 | 2020-01-23 |
| 1710517537 | Greater Elgin Family Care Center Integrated Health Home | Clinic/Center | 1100 Shirley Ave, Streamwood, IL 60107-3068 | 2020-01-21 |
| 1215578109 | Board of Trustees of Southern Illinois University | Clinic/Center | 205 S 24th St Ste 100, Quincy, IL 62301-4446 | 2019-10-02 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1427600345 | The Board of Trustees of The University of Illinois | Clinic/Center | 6835 S Normal Blvd, Chicago, IL 60621-2535 | 2019-07-11 |
| Find all providers with the same taxonomy | ||||
| City | MURPHYSBORO |
| Zip Code | 62966 |
Please comment or provide details below to improve the information on SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP.
| 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.