PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION (NPI# 1497861330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497861330 |
| Entity Type | Organization |
| Organization Name | PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION |
| Other Organization Name | PASSAVANT AREA CHILDRENS HOSPITAL |
| Practice Address |
1600 W Walnut St Jacksonville IL 62650-1136 |
| Practice Telephone | 2172459541 |
| Practice Fax Number | 2174798781 |
| Mailing Telephone | 2172459541 |
| Mailing Fax Number | 2174798781 |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2018-04-26 |
| Authorized Official Name | MR. HARRY M SCHMIDT (PRESIDENT & CEO) |
| Authorized Official Telephone | 2172459541 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEMORIAL HEALTH SYSTEM |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC2000X |
General Acute Care Hospital Specialization: Children |
========= | IL | Hospitals |
| Other Name | Type Code |
|---|---|
| PASSAVANT AREA CHILDRENS HOSPITAL | Other Name - Individual/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 |
| 1174580831 | Passavant Memorial Area Hospital Association | General Acute Care Hospital | 1600 W Walnut St, Jacksonville, IL 62650 | 2006-04-27 |
| Street Address |
1600 W WALNUT ST |
| City | JACKSONVILLE |
| State | IL |
| Zip Code | 62650-1136 |
| 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 | 282NC2000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Children |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457991523 | Southern Baptist Hospital of Florida Inc | General Acute Care Hospital | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2020-01-07 |
| 1578620449 | Southern Baptist Hospital of Florida Inc | General Acute Care Hospital | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2007-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831518539 | Anita Gupta | General Acute Care Hospital | 225 East Chicago Avenue Box -152, Chicago, IL 60611-2605 | 2014-04-09 |
| 1073855623 | The University of Chicagp | General Acute Care Hospital | 5841 S Maryland Ave Mc6082, University of Chicago, Chicago, IL 60637-1419 | 2013-03-21 |
| 1699020370 | Gregory Hansen | General Acute Care Hospital | 225 E. Chicago Avenue, Box 51, Division of Neurology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611 | 2012-07-18 |
| 1831472380 | Advocate Hope Children's Hospital | General Acute Care Hospital | 10515 Lexington Ln., Frankfort, IL 60423-2209 | 2011-09-21 |
| 1285946293 | Mt. Sinai Hospital | General Acute Care Hospital | 15 California Ave., F 444, Chicago, IL 60608-3640 | 2010-07-07 |
| 1265752844 | Hshs Medical Group | General Acute Care Hospital | 1900 E Lake Shore Dr Ste 330, Suite 330, Decatur, IL 62521-3848 | 2010-06-07 |
| 1326288465 | Harvey Buchman | General Acute Care Hospital | 1125 N Bluebonnet Ln, Hoffman Estates, IL 60169-4430 | 2009-03-03 |
| 1801058086 | Children's Memorial Hospital | General Acute Care Hospital | 1250 S Michigan Ave Apt 810, Chicago, IL 60605-3268 | 2008-06-27 |
| 1659545986 | Mount Sinai Medical Center | General Acute Care Hospital | 5030 N Ridgeway Ave Unit 2, Chicago, IL 60625-6022 | 2008-04-17 |
| 1619021359 | Childrens Memorial Hospital | General Acute Care Hospital | 2731 Harrison St, Evanston, IL 60201-1215 | 2007-01-22 |
| Find all providers with the same taxonomy | ||||
| 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.