ST. MARY'S HOSPITAL (NPI# 1285630624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285630624 |
| Entity Type | Organization |
| Organization Name | ST. MARY'S HOSPITAL |
| Practice Address |
205 Huron Irvington IL 62848 |
| Mailing Address |
Po Box 503861 Saint Louis MO 63150-0001 |
| Practice Telephone | 6182496203 |
| Mailing Telephone | 6182496203 |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MR. BRUCE MERRELL (PRESIDENT) |
| Authorized Official Telephone | 6184366205 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. MARY'S HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
0002642 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | HEALTHLINK | 128375 | 01 |
| IL | BLUE CROSS BLUE SHIELD | 9515007 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992931232 | St. Mary's Hospital | Early Intervention Provider Agency | 9226 Avenue J, Brooklyn, Brooklyn, NY 11236-3935 | 2009-06-01 |
| 1932333994 | St. Mary's Hospital | Physical Therapist | 619 4th St, Kamiah, ID 83636 | 2009-05-06 |
| 1427261007 | St. Mary's Hospital | General Acute Care Hospital | 365 Harding Ave, Apt. 2, Clifton, NJ 07011-3626 | 2007-05-08 |
| 1578684023 | St. Mary's Hospital | Community Based Residential Treatment Facility, Mental Illness | 530 Main Ave, Passaic, NJ 07055-5700 | 2007-04-03 |
| 1750402202 | St. Mary's Hospital | Residential Treatment Facility, Emotionally Disturbed Children | 33 Mineral Spring Ave, Passaic, NJ 07055-2512 | 2007-04-03 |
| 1366480394 | St. Mary's Hospital | Nurse Practitioner | 501 Oak, Nezperce, ID 83543 | 2006-06-03 |
| 1568400562 | St. Mary's Hospital | Nurse Practitioner | 518 Oak, Kamiah, ID 83536 | 2006-06-02 |
| 1770521817 | St. Mary's Hospital | Nurse Practitioner | 320 N Division, Craigmont, ID 83523 | 2006-06-02 |
| 1790789451 | St. Mary's Hospital | Clinic/Center | 825 New York Dr, Ste 2, Vandalia, IL 62471-1044 | 2005-06-10 |
| 1356725618 | St. Mary's Hospital | Long Term Care Hospital | 56 Franklin St, Waterbury, CT 06706-1253 | 2015-07-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST MARY'S HOSPITAL FOR CHILDREN, INC. | 2901 216th St, Bayside, NY 11360-2810 |
| System for Award Management (SAM) Entities | ST MARY'S HOSPITAL MEDICAL CENTER | 700 S Park St, Madison, WI 53715-1849 |
| System for Award Management (SAM) Entities | ST MARY'S HOSPITAL OF SUPERIOR | 3500 Tower Ave, Superior, WI 54880-5335 |
| Colorado Business Entities | St. Mary's Hospital & Medical Center Medical Staff | 2635 N 7th St, Grand Junction, CO 81501 |
| Washington State Corporations | ST. MARY'S HOSPITAL & MEDICAL CENTER, INC. | 500 Eldorado Blvd Ste 4300, Attn Chief Legal Officer, Broomfield, CO 80021 |
| Colorado Business Entities | ST. MARY'S HOSPITAL & MEDICAL CENTER, INC. | 2635 N. 7th Street, Grand Junction, CO 81501 |
| Colorado Business Entities | ST. MARY'S HOSPITAL FOUNDATION | 2635 N 7th Street, Grand Junction, CO 81501 |
| System for Award Management (SAM) Entities | ST. MARY'S HOSPITAL FOUNDATION | 2635 N 7th St, Grand Junction, CO 81501-8209 |
| System for Award Management (SAM) Entities | ST. MARY'S HOSPITAL LACOR | Juba Road, Gulu, , UGA |
| Massachusetts Corporations | ST. MARY'S HOSPITAL, INC. | 901 45th St., W. Palm Beach, FL 33416 |
| Street Address |
205 HURON |
| City | IRVINGTON |
| State | IL |
| Zip Code | 62848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922145002 | Jerry L. Beguelin, Md, PC | Family Medicine | 205 Huron, Irvington, IL 62848 | 2007-01-30 |
| 1518059963 | Rebecca Steinmann | Physical Medicine & Rehabilitation | 205 Huron, Irvington, IL 62848 | 2006-09-29 |
| 1013009471 | Sheree Jones | Physical Medicine & Rehabilitation | 205 Huron, Irvington, IL 62848 | 2006-09-29 |
| 1871685701 | David Brent Swartzlander | Physical Medicine & Rehabilitation | 205 Huron, Irvington, IL 62848 | 2006-09-28 |
| 1598857427 | Patricia Neudecker | Physical Medicine & Rehabilitation | 205 Huron, Irvington, IL 62848 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053666792 | Christy Kelley | Nurse Practitioner | 205 East Huron St., Irvington, IL 62848 | 2012-07-18 |
| 1558312595 | Richard H Garretson | Family Medicine | 205 Huron St., Irvington, IL 62848 | 2006-05-15 |
| 1649385279 | Jean Ann Phemister | Physician Assistant | 510 Lincoln Drive, Sourthern Orthopedic Associates Sc, Herrin, IL 62848 | 2006-08-21 |
| 1427251610 | Irvington Cc Sch Dist 11 | Local Education Agency (LEA) | 500 Superior, Irvington, IL 62848-0130 | 2007-06-06 |
| 1417371485 | Sara Mckinzie | Nurse Practitioner | 205 E Huron, Irvington, IL 62848-0190 | 2014-02-12 |
| 1891736062 | Bandys Apothecary Shops, Inc | Durable Medical Equipment & Medical Supplies | 207 Huron, Irvington, IL 62848-0526 | 2006-06-09 |
| 1245228881 | Jerry Beguelin | Family Medicine | 205 Huron Street, Irvington, IL 62848-3348 | 2005-10-07 |
| 1710441563 | Nora Fitzgerald | Registered Nurse | 302 E Pepin, Irvington, IL 62848-6284 | 2019-01-25 |
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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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.