JERSEY COMMUNITY HOSPITAL (NPI# 1730584806) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730584806 |
| Entity Type | Organization |
| Organization Name | JERSEY COMMUNITY HOSPITAL |
| Other Organization Name | JCH MEDICAL GROUP-ALTON PSYCH |
| Practice Address |
815 E 5th St Suite 205 Alton IL 62002-6471 |
| Mailing Address |
390 Maple Summit Rd Jerseyville IL 62052-2000 |
| Practice Telephone | 6184631649 |
| Practice Fax Number | 6184631015 |
| Mailing Telephone | 6184987518 |
| Mailing Fax Number | 6184983052 |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2014-11-17 |
| Authorized Official Name | MRS. BETH A KING (CFO) |
| Authorized Official Telephone | 6184988350 |
| Is Organization Subpart | Y |
| Parent Organization Name | JERSEY COMMUNITY HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
0001156 | IL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| JCH Medical Group-Alton Psych | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285272807 | Jersey Community Hospital | Obstetrics & Gynecology | #2 Memorial Drive, Suite 203, Alton, IL 62002 | 2019-12-13 |
| 1770988735 | Jersey Community Hospital | Clinic/Center | 414 S State St, Roodhouse, IL 62082-1544 | 2014-11-03 |
| 1922403096 | Jersey Community Hospital | Obstetrics & Gynecology | 2 Memorial Dr Ste 203, Alton, IL 62002-6723 | 2014-10-30 |
| 1700423696 | Jersey Community Hospital | Family Medicine | 903 S State St, Jerseyville, IL 62052-2344 | 2019-12-10 |
| 1710461777 | Jersey Community Hospital | Durable Medical Equipment & Medical Supplies | 400 Maple Summit Rd, Suite 100, Jerseyville, IL 62052-2028 | 2018-09-17 |
| 1548744501 | Jersey Community Hospital | Social Worker | 220 E County Rd, Jerseyville, IL 62052-3125 | 2018-09-17 |
| 1659750818 | Jersey Community Hospital | Family Medicine | 270 Maple Summit Rd, Jerseyville, IL 62052-2004 | 2015-05-21 |
| 1689079642 | Jersey Community Hospital | Clinic/Center | 523 S Main St, Carrollton, IL 62016-1256 | 2014-11-03 |
| 1417352527 | Jersey Community Hospital | Clinic/Center | 2 Myrtle Lane, Hardin, IL 62047 | 2014-10-31 |
| 1114322286 | Jersey Community Hospital | Pediatrics | 1440 W Walnut St, Suite 2a, Jacksonville, IL 62650-1143 | 2014-10-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | JERSEY COMMUNITY HOSPITAL DISTRICT | 400 Maple Summit Rd, Jerseyville, IL 62052-2028 |
| Street Address |
815 E 5TH ST SUITE 205 |
| City | ALTON |
| State | IL |
| Zip Code | 62002-6471 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952410060 | Mike P. Homan | Social Worker | 815 E 5th St, Suite 101, Alton, IL 62002 | 2006-08-30 |
| 1548894736 | Kelsey Michele Cunningham | Physical Therapist | 815 E 5th St, Alton, IL 62002-6471 | 2020-02-26 |
| 1417495896 | Alyssa Embick | Occupational Therapist | 815 E 5th St, Alton, IL 62002-6471 | 2017-02-06 |
| 1205373008 | Kirstin Fischer | Physical Therapist | 815 E 5th St, Alton, IL 62002-6471 | 2017-01-31 |
| 1669824439 | Bi-state Oral and Facial Surgery, LLC | Dentist | 815 E 5th St, Suitw 411, Alton, IL 62002-6471 | 2016-07-06 |
| 1023415213 | Lea Anne Varble | Social Worker | 815 E 5th St, Suite 101, Alton, IL 62002-6471 | 2014-12-03 |
| 1457604704 | Staci M Knox | Social Worker | 815 E 5th St, Suite 101, Alton, IL 62002-6471 | 2012-10-24 |
| 1861740375 | Frances Ann Young | Physical Therapist | 815 E 5th St, Suite A, Alton, IL 62002-6471 | 2012-08-15 |
| 1043566425 | Kelly Ann Bogowith | Physical Therapist | 815 E 5th St, Suite A, Outpatient Rehabilitation Services, Alton, IL 62002-6471 | 2012-08-03 |
| 1316233265 | Manpreet Kaur Sandhu | Internal Medicine | 815 E 5th St, Suite 303, Alton, IL 62002-6471 | 2011-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285272807 | Jersey Community Hospital | Obstetrics & Gynecology | #2 Memorial Drive, Suite 203, Alton, IL 62002 | 2019-12-13 |
| 1912540659 | Kelsi N Harre | Community Health Worker | 2603 N. Rogers Ave., Alton, IL 62002 | 2019-10-25 |
| 1841848322 | Destiny L Miller | Technician | 3429 Meridocia St, Alton, IL 62002 | 2019-08-28 |
| 1942854633 | Jessica Leigh Jump | Speech-Language Pathologist | 453 Bluff Street, Alton, IL 62002 | 2019-07-30 |
| 1194380741 | Vasiliki Kytridou | Dentist | 2800 College Avenue Southern Il University School of De, Building 285, Alton, IL 62002 | 2019-05-08 |
| 1982125910 | Amy Nicole Spalding | Social Worker | 1123 Harrison St, Alton, IL 62002 | 2017-06-29 |
| 1962856310 | Patricia Gregory | Social Worker | 5090 Humbert Rd, Alton, IL 62002 | 2016-04-21 |
| 1447612510 | Alanna Lynn Mcnelly | Chiropractor | 219 Piasa St, Suite 200, Alton, IL 62002 | 2016-03-28 |
| 1174983050 | Roberta's Lovely Ladies Boutique | Mastectomy Fitter | 603 W. Delmar, Alton, IL 62002 | 2016-03-04 |
| 1184081556 | Darcy Graham | Nurse Practitioner | 4 Memorial Dr # 210, Alton, IL 62002 | 2016-01-15 |
| Find all providers in zip 62002 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033203013 | Mirza S A Baig | Psychiatry & Neurology | 2615 Edwards St, Alton, IL 62002-3915 | 2006-10-03 |
| 1689693616 | Kanwal Mahmood | Psychiatry & Neurology | 4500 College Ave, Alton, IL 62002-5051 | 2006-07-19 |
| 1104007467 | Scott J Arbaugh Md | Psychiatry & Neurology | 1 Memorial Dr, Alton, IL 62002-6722 | 2007-11-15 |
| 1902004203 | Sunil Gangwani | Psychiatry & Neurology | 4 Memorial Dr Ste 210, Alton, IL 62002-6751 | 2007-07-07 |
| 1194853069 | Illini Medical Associates Sc | Psychiatry & Neurology | 815 E 5th St, Suite 205, Alton, IL 62002-6471 | 2007-03-01 |
| 1477608032 | Paul Edward Carter | Psychiatry & Neurology | 2615 Edwards St, Alton, IL 62002 | 2007-01-24 |
| 1821158288 | Susan Sherman | Psychiatry & Neurology | 2615 Edwards St, Alton, IL 62002-3915 | 2006-12-08 |
| 1902995798 | Syed Shahid Mumtaz | Psychiatry & Neurology | 2615 Edwards St, Alton, IL 62002-3915 | 2006-10-12 |
| 1114031622 | Rupa Maitra | Psychiatry & Neurology | 4500 College Ave, Alton, IL 62002-5051 | 2006-08-19 |
| 1003920539 | David Montani | Psychiatry & Neurology | 4500 College Ave, Alton, IL 62002-5051 | 2006-08-19 |
| Find all providers in ALTON | ||||
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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.