CHARLESTON PRIMARY CARE INC. (NPI# 1770905952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770905952 |
Entity Type | Organization |
Organization Name | CHARLESTON PRIMARY CARE INC. |
Practice Address |
506 W Lincoln Ave Suite 200 Charleston IL 61920-2453 |
Practice Telephone | 2173488730 |
Practice Fax Number | 2173457146 |
Mailing Telephone | 2173488730 |
Mailing Fax Number | 2173457146 |
Enumeration Date | 2014-01-07 |
Last Update Date | 2014-01-07 |
Authorized Official Name | DANELLE JACKSON (OWNER) |
Authorized Official Telephone | 2172766421 |
Authorized Official Credential | MSN, APN, NP-C |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
Street Address |
506 W LINCOLN AVE SUITE 200 |
City | CHARLESTON |
State | IL |
Zip Code | 61920-2453 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912981390 | David C. Hunter | Counselor | 506 W Lincoln Ave, Suite 1000, Charleston, IL 61920-2453 | 2005-11-30 |
1881055184 | Holly Godden | Counselor | 506 W Lincoln Ave, Suite 500, Charleston, IL 61920-2453 | 2016-03-14 |
1497942791 | L.e. Mcneill, Md Sc | Family Medicine | 506 W Lincoln Ave, Suites 200a&b, Charleston, IL 61920-2453 | 2007-10-01 |
1790976017 | Jane Elizabeth Wilson | Counselor | 506 W Lincoln Ave, Suite 1000, Charleston, IL 61920-2453 | 2007-08-05 |
1346456068 | Virginia Alberta Croft | Speech-Language Pathologist | 506 W Lincoln Ave, Charleston, IL 61920-2453 | 2007-05-16 |
1659441210 | New Leaf Professional Counseling | Counselor | 506 W Lincoln Ave, Suite 1000, Charleston, IL 61920-2453 | 2006-11-09 |
1891897773 | Leland E. Mcneill | Family Medicine | 506 W Lincoln Ave, Suites 200 A and B, Charleston, IL 61920-2453 | 2006-09-02 |
1396853008 | Jason B Jerabek | Family Medicine | 506 W Lincoln Ave, Suite 200 A, Charleston, IL 61920-2453 | 2006-08-25 |
1588770424 | Judith Lidy | Nurse Practitioner | 506 W Lincoln Ave, Suite 200 A, Charleston, IL 61920-2453 | 2006-08-22 |
1619953189 | Beverly J. Voris | Counselor | 506 W Lincoln Ave, Suite 400, Charleston, IL 61920-2453 | 2005-12-16 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124643879 | Jenna Kay Mortensen | Speech-Language Pathologist | 2086 7th Street, Charleston, IL 61920 | 2020-06-09 |
1255954566 | Christina L. White | Nurse Practitioner | 1199 Persimmon Rd, Charleston, IL 61920 | 2020-05-20 |
1679066773 | Jennifer Hess | Specialist/Technologist | 2506 Lantz Building, Charleston, IL 61920 | 2018-06-13 |
1134647969 | Nichole C Ogilvie | Student in an Organized Health Care Education/Training Program | 917 4th Street Apt 19, Charleston, IL 61920 | 2017-08-31 |
1467970319 | Marcus Roach | Physical Therapy Assistant | 912 Oakcrest Dr. Apt D, Charleston, IL 61920 | 2017-08-30 |
1114478500 | 5 Guys Rx II LLC | Pharmacy | 1 W Lincoln Ave, Charleston, IL 61920 | 2016-10-20 |
1649723206 | Bright Minds Educational Program Inc | Developmental Therapist | 7704 Deerpath Road, Charleston, IL 61920 | 2016-08-01 |
1760843379 | Lisa Price | Nurse Practitioner | 2040 Lincoln Ave, Suite 100, Charleston, IL 61920 | 2016-03-09 |
1104243385 | Nathan David Schwartzkopf | Specialist/Technologist | 1340 A Street, Charleston, IL 61920 | 2014-03-25 |
1558694349 | Emily Schilling | Specialist/Technologist | 2350 Harrison Avenue, Charelston, IL 61920 | 2009-09-10 |
Find all providers in zip 61920 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
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1174520068 | Jeffery L Deal | Clinic/Center | 1938 Charlie Hall Blvd Unit B, Charleston, SC 29414-6099 | 2005-07-07 |
1033778642 | Kanawha County Emergency Ambulance Authority Health and Wellness Board | Clinic/Center | 601 Brooks St, Charleston, WV 25301-1319 | 2019-06-07 |
1376033829 | Charleston Medical Associates | Clinic/Center | 1483 Tobias Gadson Blvd Ste 101, Charleston, SC 29407-4795 | 2018-05-10 |
1528560083 | Kanawha County Emergency Ambulance Authority | Clinic/Center | 601 Brooks St, Charleston, WV 25301-1319 | 2018-03-01 |
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1336577238 | Western Arkansas Primary Care | Clinic/Center | 2617 E Main St, Charleston, AR 72933-9637 | 2013-10-31 |
1417389594 | Building Blocks Family Chiropractic. LLC | Clinic/Center | 1001 Physicians Dr, Charleston, SC 29414-5746 | 2013-07-31 |
Find all providers in CHARLESTON |
City | CHARLESTON |
Zip Code | 61920 |
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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.