CARBONDALE RURAL HEALTH CLINIC (NPI# 1417013095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417013095 |
| Entity Type | Organization |
| Organization Name | CARBONDALE RURAL HEALTH CLINIC |
| Practice Address |
2601 W Main St Carbondale IL 62901-1031 |
| Practice Telephone | 6185495361 |
| Practice Fax Number | 6185495128 |
| Mailing Telephone | 6185495361 |
| Mailing Fax Number | 6185495128 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MR. ALLAN N NORMAN (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6185495361 |
| Is Organization Subpart | Y |
| Parent Organization Name | CARBONDALE CLINIC, S. C |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Street Address |
2601 W MAIN ST |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-1031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548261399 | Jeffrey M Lehman | Allergy & Immunology | 2601 W Main St, Carbondale, IL 62901-1031 | 2005-08-02 |
| 1043846421 | Lindsay B Casolari | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2020-03-18 |
| 1194367318 | Jessica Oakley | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2019-10-09 |
| 1609424399 | Alexis Korbar | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2019-08-27 |
| 1184196883 | Leslie Ann Hickman | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-12-19 |
| 1679041685 | Kirsten Anne Beyers | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-11-07 |
| 1457834178 | Brittany Elizabeth Pierce | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-09-09 |
| 1306322110 | Katharine Johnson | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-07-15 |
| 1437699147 | Gina Gladson | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2017-02-28 |
| 1902349863 | Sarah Elizabeth Ruth Shannon | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901 | 2016-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396386181 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak St Ste 100, Carbondale, IL 62901-1496 | 2019-10-02 |
| 1154510808 | Southern Illinois Medical Services, Nfp | Clinic/Center | 2601 W Main St, Carbondale, IL 62901-1031 | 2007-10-18 |
| 1508924093 | Siu Physicians & Surgeons, Inc. | Clinic/Center | 305 W Jackson St, Suite 200, Carbondale, IL 62901-1474 | 2006-12-05 |
| 1215978127 | Board of Trustees of Southern Illinois University | Clinic/Center | 305 W Jackson St, Suite 200, Carbondale, IL 62901-1474 | 2006-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043872781 | Mendota Community Hospital | Clinic/Center | 1401 E 12th St Ste 400, Mendota, IL 61342-9216 | 2019-07-02 |
| 1114582913 | Hammond Henry Dist Hospital | Clinic/Center | 203 W Front St, Annawan, IL 61234-7756 | 2019-05-07 |
| 1841763810 | Heartland Women's Healthcare Ltd | Clinic/Center | 24 Veterans Dr, Harrisburg, IL 62946-3320 | 2019-01-02 |
| 1821561895 | Heartland Women's Healthcare Ltd | Clinic/Center | 215 N Logan St Ste A, West Frankfort, IL 62896-2314 | 2019-01-02 |
| 1578040275 | Osf Healthcare System | Clinic/Center | 230 S Exchange St, Galva, IL 61434-1871 | 2018-07-25 |
| 1700380219 | Toofan Medical Holdings, Ltd. | Clinic/Center | 1510 W Springfield Rd Ste A, Taylorville, IL 62568-2764 | 2018-03-20 |
| 1326542903 | Toofan Medical Holdings, Ltd. | Clinic/Center | 1001 Avenue of Mid America Ste 4, Effingham, IL 62401-4634 | 2018-03-20 |
| 1649795659 | Harrisburg Medical Center Inc | Clinic/Center | 3106 Outer Dr Ste 200, Marion, IL 62959-5270 | 2017-08-10 |
| 1588186308 | Wabash General Hospital District | Clinic/Center | 1430 College Dr Ste A, Mount Carmel, IL 62863-2649 | 2017-07-13 |
| 1356884993 | Gibson Community Hospital Association | Clinic/Center | 510 Prairie Ln Unit B, Cissna Park, IL 60924-9710 | 2016-11-30 |
| Find all providers with the same taxonomy | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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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.