PHYSICIAN SERVICES CORP OF SOUTHERN ILLINOIS (NPI# 1548264237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548264237 |
| Entity Type | Organization |
| Organization Name | PHYSICIAN SERVICES CORP OF SOUTHERN ILLINOIS |
| Other Organization Name | ST MARYS GOOD SAMARITAN MEDICAL GROUP |
| Practice Address |
8 Cusumano Professional Plaza Dr Mount Vernon IL 62864-6736 |
| Mailing Address |
413 Main St Mount Vernon IL 62864 |
| Practice Telephone | 6182427819 |
| Mailing Telephone | 6185329350 |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2009-04-02 |
| Authorized Official Name | MR. RICHARD HUNTINGTON (VP FINANCIAL DEVELOPMENT) |
| Authorized Official Telephone | 6182412204 |
| Is Organization Subpart | Y |
| Parent Organization Name | PHYSICIAN SERVICES CORP OF SOUTHERN ILLINOIS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
0004705 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 430653587005 | 05 |
| Other Name | Type Code |
|---|---|
| St marys Good Samaritan medical group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619109543 | Physician Services Corp of Southern Illinois | Clinic/Center | 1250 W Whittaker St, Salem, IL 62881-1917 | 2009-08-11 |
| 1740421536 | Physician Services Corp of Southern Illinois | Clinic/Center | 430 N Pleasant Ave, Centralia, IL 62801-3006 | 2009-03-09 |
| Street Address |
8 CUSUMANO PROFESSIONAL PLAZA DR |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-6736 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740779081 | Julie Ann Cammon Rinehart | Advanced Practice Midwife | 8 Cusumano Professional Plaza Dr, Mount Vernon, IL 62864-6736 | 2018-05-02 |
| 1417468190 | Kelli Mowrer | Nurse Practitioner | 8 Cusumano Professional Plaza Dr, Mount Vernon, IL 62864-6736 | 2017-10-20 |
| 1346550910 | Keith Allen Suedmeyer | Social Worker | 8 Cusumano Professional Plaza Dr, Mount Vernon, IL 62864-6736 | 2010-10-18 |
| 1033440722 | Asbery and Associates Ob Gyn LLC | Obstetrics & Gynecology | 8 Cusumano Professional Plaza Dr, Mount Vernon, IL 62864-6736 | 2010-01-20 |
| 1467509109 | Alice Malone | Psychiatry & Neurology | 8 Cusumano Professional Plaza Dr, Mount Vernon, IL 62864-6736 | 2007-01-04 |
| 1417023284 | Leslie L Simonton-smith | Obstetrics & Gynecology | 8 Cusumano Professional Plaza Dr, Mount Vernon, IL 62864-6736 | 2006-11-25 |
| 1982704995 | Leeann Stanley | Physical Medicine & Rehabilitation | 8 Cusumano Professional Plaza Dr, Mount Vernon, IL 62864-6736 | 2006-09-22 |
| 1437106101 | David S Asbery | Specialist | 8 Cusumano Professional Plaza Dr, Mount Vernon, IL 62864-6736 | 2006-05-28 |
| 1346248978 | Robert A Brown | Obstetrics & Gynecology | 8 Cusumano Professional Plaza Dr, Mount Vernon, IL 62864-6736 | 2005-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396263000 | Rockcastle County Hospital, Inc. | Clinic/Center | 1770 Lake Cumberland Rd, Mount Vernon, KY 40456-8431 | 2017-09-01 |
| 1578090403 | Advanced Family Medical Clinic Mount Vernon | Clinic/Center | 50 Lovell Court, Mount Vernon, KY 40456-2964 | 2017-05-23 |
| 1306114004 | Lower Oconee Community Hospital, Inc | Clinic/Center | 421 W Robinson Dr, Mount Vernon, GA 30445-2935 | 2011-12-08 |
| 1871706374 | John Hall Md Rural Health Services | Clinic/Center | 3505 Broadway St Ste A, Mount Vernon, IL 62864-2202 | 2007-05-08 |
| 1164547287 | Lower Oconee Community Hospital, Inc | Clinic/Center | 441 W Broad Street, Mount Vernon, GA 30445-2629 | 2007-03-20 |
| 1497823314 | Southside Medical Clinic Inc | Clinic/Center | 913 South 10th Street, Mount Vernon, IL 62864-5313 | 2006-11-30 |
| 1669466686 | Crossroads Physician Corp | Clinic/Center | 3505 Broadway St, Mount Vernon, IL 62864-2202 | 2005-09-06 |
| 1912900234 | Family Care Network, Pllc | Clinic/Center | 2116 E. Section St., Mount Vernon, WA 98274 | 2005-05-31 |
| 1447814405 | National Healthcare of Mt Vernon Inc | Clinic/Center | 4101 N Water Tower Pl, Mount Vernon, IL 62864-6296 | 2019-04-25 |
| 1801280409 | Heartland Women's Healthcare, Ltd | Clinic/Center | 3130 Veterans Memorial Dr, Mount Vernon, IL 62864-5951 | 2015-03-23 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
Please comment or provide details below to improve the information on PHYSICIAN SERVICES CORP OF SOUTHERN ILLINOIS.
| 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.