JULIA RACKLEY PERRY MEMORIAL HOSPITAL (NPI# 1578922050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578922050 |
| Entity Type | Organization |
| Organization Name | JULIA RACKLEY PERRY MEMORIAL HOSPITAL |
| Other Organization Name | PERRY MEMORIAL FAMILY HEALTH CLINIC |
| Practice Address |
535 Park Ave E Princeton IL 61356-3901 |
| Practice Telephone | 8158754531 |
| Practice Fax Number | 8158762118 |
| Mailing Telephone | 8158754531 |
| Mailing Fax Number | 8158762118 |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2020-03-18 |
| Authorized Official Name | JEAN WELTE (MEDICAL STAFF SERVICES COORDINATOR) |
| Authorized Official Telephone | 8158762293 |
| Is Organization Subpart | Y |
| Parent Organization Name | JULIA RACKLEY PERRY MEMORIAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
0001883 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ========= | 05 |
| Other Name | Type Code |
|---|---|
| Perry Memorial Family Health Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932610110 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 530 Park Ave E Fl 3, Princeton, IL 61356-3901 | 2017-10-16 |
| 1578083051 | Julia Rackley Perry Memorial Hospital | Surgery | 530 Park Ave E Ste 205, Princeton, IL 61356-3902 | 2017-06-26 |
| 1629598602 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 327 Edward St, Henry, IL 61537-1539 | 2017-06-21 |
| 1033649967 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 105 N Main St Ste 1, Walnut, IL 61376-9707 | 2017-06-13 |
| 1124021308 | Julia Rackley Perry Memorial Hospital | General Acute Care Hospital | 530 Park Ave E, Princeton, IL 61356-3901 | 2005-05-23 |
| 1134695422 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 327 Edward St, Henry, IL 61537-1539 | 2018-10-15 |
| 1043786338 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 105 N Main St Ste 1, Walnut, IL 61376-9707 | 2018-10-15 |
| 1952877243 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 530 Park Ave E Ste 303, Princeton, IL 61356-3903 | 2018-10-15 |
| 1699229823 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 2128 N Main St, Princeton, IL 61356-9728 | 2016-08-04 |
| 1326408204 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 2128 N Main St, Princeton, IL 61356-9728 | 2016-03-04 |
| Street Address |
535 PARK AVE E |
| City | PRINCETON |
| State | IL |
| Zip Code | 61356-3901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598712218 | Manuel R Ascano Sr. | Family Medicine | 535 Park Ave E, Princeton, IL 61356-2537 | 2006-05-28 |
| 1093379802 | Ariel E Swanson | Social Worker | 535 Park Ave E, Princeton, IL 61356 | 2019-04-26 |
| 1184194813 | Abby Ruth Vladika | Nurse Practitioner | 535 Park Ave E, Princeton, IL 61356-2537 | 2018-11-26 |
| 1588181531 | Bianca A Ramiro | Nurse Practitioner | 535 Park Ave E, Princeton, IL 61356-2537 | 2017-08-29 |
| 1750739900 | Shitaldas Jamandas Pamnani | Internal Medicine | 535 Park Ave E, Princeton, IL 61356 | 2016-05-28 |
| 1306286950 | Christopher Thomas Blanford | Family Medicine | 535 Park Ave E, Princeton, IL 61356-2537 | 2013-06-27 |
| 1366795049 | Carol A Debruhl | Nurse Practitioner | 535 Park Ave E, Princeton, IL 61356-2537 | 2012-10-18 |
| 1760733992 | Karen S Nenne | Nurse Practitioner | 535 Park Ave E, Princeton, IL 61356-2537 | 2012-09-27 |
| 1447437702 | Anna M Freeman | Nurse Practitioner | 535 Park Ave E, Princeton, IL 61356-2537 | 2008-01-29 |
| 1659312924 | Robert E Mestan | Family Medicine | 535 Park Ave E, Princeton, IL 61356-2537 | 2006-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548698558 | Shelley Gorenz | Counselor | 1009 S. Main St., Princeton, IL 61356 | 2013-10-30 |
| 1780016626 | Jennifer Phillips | Pharmacist | 610 N. Main St., Princeton, IL 61356 | 2013-08-02 |
| 1477848521 | Princeton Prompt Care LLC | Clinic/Center | 2128 North Main Street, Princeton, IL 61356 | 2011-06-16 |
| 1306014196 | Lifefit Physical Rehab, Ltd. | Clinic/Center | 1225 N. Sixth St., Princeton, IL 61356 | 2008-02-14 |
| 1568669778 | Hawthorne Inn Supportive Living Facility | Assisted Living Facility | 136 N. Sixth St., Princeton, IL 61356 | 2007-06-29 |
| 1720209240 | Michelle Lee Mortensen | Music Therapist | 816 S. First St., Princeton, IL 61356 | 2007-05-01 |
| 1073733465 | Jarred Allen Farrell | Chiropractor | 682 East Peru Street, Princeton, IL 61356 | 2007-04-26 |
| 1952488397 | Donald R Marion | Optometrist | 2 Park Avenue West, Princeton, IL 61356 | 2006-11-01 |
| 1427138247 | Bruce Waldo Shriver | Dentist | 422 E Peru St, Princeton, IL 61356 | 2006-10-16 |
| 1871689612 | Jason A Monroe | Dentist | 334 Backbone Rd East, Princeton, IL 61356 | 2006-10-05 |
| Find all providers in zip 61356 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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|---|---|---|---|---|
| 1447728043 | Baptist Health Medical Group Inc | Clinic/Center | 605 S Jefferson St, Princeton, KY 42445-2173 | 2018-11-13 |
| 1992286207 | Caldwell County Hospital, Inc | Clinic/Center | 302 Micbeth Dr, Princeton, KY 42445-6332 | 2018-08-24 |
| 1699229823 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 2128 N Main St, Princeton, IL 61356-9728 | 2016-08-04 |
| 1609279876 | Good Samaritan Hospital Physician Services, Inc | Clinic/Center | 314 N Main St, Princeton, IN 47670-1514 | 2014-10-02 |
| 1952514549 | Tammy Hart, Md, PC | Clinic/Center | 400 N Fullerton St, Princeton, MO 64673-1418 | 2007-05-08 |
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| 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 |
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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.