ST. MARY'S HOSPITAL (NPI# 1790789451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790789451 |
| Entity Type | Organization |
| Organization Name | ST. MARY'S HOSPITAL |
| Practice Address |
825 New York Dr Ste 2 Vandalia IL 62471-1044 |
| Mailing Address |
Po Box 503861 Saint Louis MO 63150-0001 |
| Practice Telephone | 6182830600 |
| Mailing Telephone | 6184368000 |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MR. BRUCE MERRELL (PRESIDENT) |
| Authorized Official Telephone | 6184366205 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. MARY'S HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
0002642 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | HEALTHLINK | 259114 | 01 |
| IL | BLUE CROSS BLUE SHIELD | 2620625 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992931232 | St. Mary's Hospital | Early Intervention Provider Agency | 9226 Avenue J, Brooklyn, Brooklyn, NY 11236-3935 | 2009-06-01 |
| 1932333994 | St. Mary's Hospital | Physical Therapist | 619 4th St, Kamiah, ID 83636 | 2009-05-06 |
| 1427261007 | St. Mary's Hospital | General Acute Care Hospital | 365 Harding Ave, Apt. 2, Clifton, NJ 07011-3626 | 2007-05-08 |
| 1578684023 | St. Mary's Hospital | Community Based Residential Treatment Facility, Mental Illness | 530 Main Ave, Passaic, NJ 07055-5700 | 2007-04-03 |
| 1750402202 | St. Mary's Hospital | Residential Treatment Facility, Emotionally Disturbed Children | 33 Mineral Spring Ave, Passaic, NJ 07055-2512 | 2007-04-03 |
| 1366480394 | St. Mary's Hospital | Nurse Practitioner | 501 Oak, Nezperce, ID 83543 | 2006-06-03 |
| 1568400562 | St. Mary's Hospital | Nurse Practitioner | 518 Oak, Kamiah, ID 83536 | 2006-06-02 |
| 1770521817 | St. Mary's Hospital | Nurse Practitioner | 320 N Division, Craigmont, ID 83523 | 2006-06-02 |
| 1285630624 | St. Mary's Hospital | Clinic/Center | 205 Huron, Irvington, IL 62848 | 2005-06-21 |
| 1356725618 | St. Mary's Hospital | Long Term Care Hospital | 56 Franklin St, Waterbury, CT 06706-1253 | 2015-07-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST MARY'S HOSPITAL FOR CHILDREN, INC. | 2901 216th St, Bayside, NY 11360-2810 |
| System for Award Management (SAM) Entities | ST MARY'S HOSPITAL MEDICAL CENTER | 700 S Park St, Madison, WI 53715-1849 |
| System for Award Management (SAM) Entities | ST MARY'S HOSPITAL OF SUPERIOR | 3500 Tower Ave, Superior, WI 54880-5335 |
| Colorado Business Entities | St. Mary's Hospital & Medical Center Medical Staff | 2635 N 7th St, Grand Junction, CO 81501 |
| Washington State Corporations | ST. MARY'S HOSPITAL & MEDICAL CENTER, INC. | 500 Eldorado Blvd Ste 4300, Attn Chief Legal Officer, Broomfield, CO 80021 |
| Colorado Business Entities | ST. MARY'S HOSPITAL & MEDICAL CENTER, INC. | 2635 N. 7th Street, Grand Junction, CO 81501 |
| Colorado Business Entities | ST. MARY'S HOSPITAL FOUNDATION | 2635 N 7th Street, Grand Junction, CO 81501 |
| System for Award Management (SAM) Entities | ST. MARY'S HOSPITAL FOUNDATION | 2635 N 7th St, Grand Junction, CO 81501-8209 |
| System for Award Management (SAM) Entities | ST. MARY'S HOSPITAL LACOR | Juba Road, Gulu, , UGA |
| Massachusetts Corporations | ST. MARY'S HOSPITAL, INC. | 901 45th St., W. Palm Beach, FL 33416 |
| Street Address |
825 NEW YORK DR STE 2 |
| City | VANDALIA |
| State | IL |
| Zip Code | 62471-1044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790146728 | Fayette County Hospital District | Clinic/Center | 825 New York Dr, Vandalia, IL 62471-1044 | 2016-03-18 |
| 1700176765 | Veronica Lynn Schaufelberger | Nurse Practitioner | 825 New York Dr, Suite 2, Vandalia, IL 62471-1044 | 2011-04-12 |
| 1437399938 | Michelle Schmitt | Physical Therapist | 825 New York Dr, Vandalia, IL 62471-1044 | 2009-02-24 |
| 1528263811 | Beth Hall | Physical Therapist | 825 New York Dr, Vandalia, IL 62471-1044 | 2007-06-18 |
| 1114122793 | Amy Newsom | Occupational Therapist | 825 New York Dr, Vandalia, IL 62471-1044 | 2007-06-15 |
| 1033314604 | Melissa Hutchison | Physical Therapist | 825 New York Dr, Vandalia, IL 62471-1044 | 2007-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083924740 | Micah Brasel | Optometrist | 300 W Randolph, Vandalia, IL 62471 | 2010-10-15 |
| 1154635332 | Marion Eye Centers Ltd. | Durable Medical Equipment & Medical Supplies | 300 West Randolph, Vandalia, IL 62471 | 2010-07-30 |
| 1972771699 | Community Resource Center | Community Based Residential Treatment Facility, Mental Illness | 423 W Main, Vandalia, IL 62471 | 2008-02-15 |
| 1952429078 | Julie M Gordon | Physical Therapist | 126 S. First Street, Vandalia, IL 62471 | 2007-03-27 |
| 1033200183 | Penny Attaway | Nurse Practitioner | 1404 N 5th Street, Vandalia, IL 62471 | 2006-09-27 |
| 1588773089 | Pain Relief Center of Vandalia Inc | Chiropractor | 100 N Kennedy Blvd, Vandalia, IL 62471 | 2006-08-29 |
| 1811003551 | Fayco Enterprises Inc | Day Training, Developmentally Disabled Services | 1313 Sunset Drive, Vandalia, IL 62471 | 2006-08-23 |
| 1174585384 | Vandalia Physical Therapy Ltd | Physical Therapist | 126 S. 1st St., Vandalia, IL 62471 | 2006-04-04 |
| 1548221799 | Arkom Chulamorkodt | Family Medicine | 606 W Jackson St, Vandalia, IL 62471 | 2006-03-29 |
| 1568581163 | Ashley Hadowsky | Physical Therapist | 126 S. First Street, Vandalia, IL 62471 | 2007-03-28 |
| Find all providers in zip 62471 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528185170 | Penny Attaway | Clinic/Center | 1404 N 5th St, Vandalia, IL 62471-1039 | 2007-03-26 |
| 1396861050 | Brian W Dossett Md Ltd | Clinic/Center | 1029 N 8th St, Vandalia, IL 62471-1238 | 2007-03-22 |
| 1568500510 | Fayette County Hospital District | Clinic/Center | 1442 N 8th St, Suite C, Vandalia, IL 62471-1027 | 2007-02-02 |
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|---|---|---|---|---|
| 1396386181 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak St Ste 100, Carbondale, IL 62901-1496 | 2019-10-02 |
| 1043872781 | Mendota Community Hospital | Clinic/Center | 1401 E 12th St Ste 400, Mendota, IL 61342-9216 | 2019-07-02 |
| 1114582913 | Hammond Henry Dist Hospital | Clinic/Center | 203 W Front St, Annawan, IL 61234-7756 | 2019-05-07 |
| 1841763810 | Heartland Women's Healthcare Ltd | Clinic/Center | 24 Veterans Dr, Harrisburg, IL 62946-3320 | 2019-01-02 |
| 1821561895 | Heartland Women's Healthcare Ltd | Clinic/Center | 215 N Logan St Ste A, West Frankfort, IL 62896-2314 | 2019-01-02 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.