SALEM TOWNSHIP HOSPITAL (NPI# 1629433784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629433784 |
| Entity Type | Organization |
| Organization Name | SALEM TOWNSHIP HOSPITAL |
| Other Organization Name | STH FAMILY HEALTH CARE CENTER |
| Practice Address |
1321 W Whittaker St Salem IL 62881-2013 |
| Mailing Address |
1201 Ricker Rd Salem IL 62881-4263 |
| Practice Telephone | 6185480200 |
| Practice Fax Number | 6185480924 |
| Mailing Telephone | 6185483194 |
| Mailing Fax Number | 6185480924 |
| Enumeration Date | 2015-12-16 |
| Last Update Date | 2020-01-28 |
| Authorized Official Name | MRS. KENDRA K TAYLOR (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6185483194 |
| Authorized Official Credential | MSN |
| Is Organization Subpart | Y |
| Parent Organization Name | SALEM TOWNSHIP HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| STH Family Health Care Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295739548 | Salem Township Hospital | General Acute Care Hospital | 1201 Ricker Drive, Salem, IL 62881 | 2005-06-02 |
| 1649830472 | Salem Township Hospital | Clinic/Center | 1321 W Whittaker St, Salem, IL 62881-2013 | 2019-06-14 |
| 1750429742 | Salem Township Hospital | General Acute Care Hospital | 1201 Ricker Rd, Salem, IL 62881-4263 | 2007-02-02 |
| 1518024637 | Salem Township Hospital | Internal Medicine | 1201 Ricker Rd, Salem, IL 62881-4263 | 2007-01-02 |
| 1770649931 | Salem Township Hospital | Nurse Anesthetist, Certified Registered | 1201 Ricker Drive, Salem, IL 62881 | 2006-12-29 |
| 1508922816 | Salem Township Hospital | Internal Medicine | 1201 Ricker Rd, Salem, IL 62881-4263 | 2006-12-29 |
| 1184783425 | Salem Township Hospital | Medicare Defined Swing Bed Unit | 1201 Ricker Drive, Salem, IL 62881 | 2006-12-06 |
| 1689732463 | Salem Township Hospital | Emergency Medicine | 1201 Ricker Drive, Salem, IL 62881 | 2006-12-05 |
| 1659382893 | Salem Township Hospital | Home Health | 1201 Ricker Drive, Salem, IL 62881 | 2006-08-11 |
| 1265467195 | Salem Township Hospital | Clinic/Center | 1201 Ricker Drive, Salem, IL 62881 | 2006-07-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SALEM TOWNSHIP HOSPITAL | 1201 Ricker Dr, Salem, IL 62881-4263 |
| Street Address |
1321 W WHITTAKER ST |
| City | SALEM |
| State | IL |
| Zip Code | 62881-2013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477593705 | Kimberly Victoria Barnes Reames | Internal Medicine | 1321 W Whittaker St, Salem, IL 62881-2013 | 2006-06-07 |
| 1649830472 | Salem Township Hospital | Clinic/Center | 1321 W Whittaker St, Salem, IL 62881-2013 | 2019-06-14 |
| 1548490360 | Miriam A. Baumgart | Internal Medicine | 1321 W Whittaker St, Salem, IL 62881-2013 | 2009-07-15 |
| 1902986730 | Palaniappan Suppiah | Internal Medicine | 1321 W Whittaker St, Salem, IL 62881-2013 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447776026 | Heather Krajefska | Speech-Language Pathologist | Franklin Park School, 1325 N Franklin, Salem, IL 62881 | 2017-08-16 |
| 1629510581 | Heidi V. Thompson | Nurse Practitioner | 1250 W. Whittaker, Salem, IL 62881 | 2016-11-09 |
| 1548664170 | Catherine Durbin | Nurse Practitioner | 518 South Broadway, Salem, IL 62881 | 2014-10-10 |
| 1770718439 | Community Resource Center, Inc | Community/Behavioral Health | 315 Westgate, Salem, IL 62881 | 2009-05-26 |
| 1932377652 | Community Resource Center Inc | Clinic/Center | 315 Westgate Ave, Salem, IL 62881 | 2008-02-15 |
| 1245408053 | The Manor At Salem Woods, L.p. | Assisted Living Facility | 441 S. Hotze Rd., Salem, IL 62881 | 2008-02-14 |
| 1366610321 | Penta Group Inc. | Non-emergency Medical Transport (VAN) | 300 Schoonover Drive, Salem, IL 62881 | 2008-02-13 |
| 1326192808 | Alan D Montgomery | Optometrist | 400 North Broadway, Salem, IL 62881 | 2007-01-22 |
| 1669539979 | Knevitt Inc | Ambulance | 3340 Selmaville Rd, Salem, IL 62881 | 2007-01-03 |
| 1447314737 | Gautam Jha | Internal Medicine | 1325 W. Whittaker, Suite D, Salem, IL 62881 | 2006-12-20 |
| Find all providers in zip 62881 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710373444 | Larry Bassinger | Family Medicine | 1300 Broadway St Ne Ste 104, Salem, OR 97301-1420 | 2015-04-09 |
| 1396144507 | Constance Johanson | Family Medicine | 3959 Croisan Creek Rd S, Salem, OR 97302-9474 | 2014-08-14 |
| 1457792699 | Sultan Seretis Bussey Hospitalist LLC | Family Medicine | 310 Route 45, Salem, NJ 08079-2064 | 2013-07-16 |
| 1629338470 | Derek Koller | Family Medicine | 6861 Lemongrass Loop Se, Salem, OR 97306-1474 | 2012-05-25 |
| 1962712927 | Paul Julian Perrin | Family Medicine | 525 Ferry St Se, Suite 203, Salem, OR 97301 | 2010-10-08 |
| 1326372558 | Robert Verne Bain | Family Medicine | 2280 Kuebler Road, South, Salem, OR 97302 | 2009-09-21 |
| 1902036320 | James A. Auerbach, M.d., P.C. | Family Medicine | 4747 Skyline Rd S, Suite 190, Salem, OR 97306-4200 | 2009-07-20 |
| 1033347430 | Jeanette Walker | Family Medicine | 5560 Witzel Rd Se, Salem, OR 97317-9142 | 2009-06-24 |
| 1871747188 | Carmelle Marie Andrine Constant | Family Medicine | 84 Highland Ave Ste 309, Salem, MA 01970-2733 | 2008-11-13 |
| 1518127927 | Mazen I Madhoun | Family Medicine | 3737 W Main St Ste 101, Salem, VA 24153-2073 | 2008-06-10 |
| Find all providers in SALEM | ||||
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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.