CHARLESTON PRIMARY CARE INC.


Address: 506 W Lincoln Ave, Suite 200, Charleston, IL 61920-2453
Phone: 2173488730

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities

Office Location

Street Address 506 W LINCOLN AVE
SUITE 200
City CHARLESTON
State IL
Zip Code 61920-2453

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

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1447758032 Crs Eyecare Services, Inc. Clinic/Center 112 Rutledge Ave Ste A, Charleston, SC 29401-1333 2018-01-29
1760829519 Health First Clinic/Center 1115 Savannah Hwy, Charleston, SC 29407-7805 2013-06-03
1235108721 Charleston Internal Medicine, LLC Clinic/Center 537 Folly Rd, Charleston, SC 29412-3007 2006-03-16
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
1639604929 Lowcountry Wellness Center LLC Clinic/Center 1941 Savage Rd Ste 100e, Charleston, SC 29407-4788 2017-04-25
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
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Competitor

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City CHARLESTON
Zip Code 61920

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Dataset Information

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.

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