JERSEY COMMUNITY HOSPITAL (NPI# 1811392970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811392970 |
| Entity Type | Organization |
| Organization Name | JERSEY COMMUNITY HOSPITAL |
| Other Organization Name | JCH MEDICAL GROUP-JERSEYVILLE |
| Practice Address |
390 Maple Summit Rd Jerseyville IL 62052-2000 |
| Practice Telephone | 6184982101 |
| Practice Fax Number | 6184988153 |
| Mailing Telephone | 6184987518 |
| Mailing Fax Number | 6184983052 |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2015-05-12 |
| 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 | 261QR1300X |
Clinic/Center Specialization: Rural Health |
0001156 | IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| JCH Medical Group-Jerseyville | 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 |
390 MAPLE SUMMIT RD |
| City | JERSEYVILLE |
| State | IL |
| Zip Code | 62052-2000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326034919 | Srirama S Kurella | Internal Medicine | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2005-09-20 |
| 1700499274 | Carrie H Purdy | Nurse Practitioner | 390 Maple Summit Rd, Illini Bldg, Jerseyville, IL 62052 | 2020-08-25 |
| 1124579099 | Mary Beck | Nurse Practitioner | 390 Maple Summit Rd, Jerseyville, IL 62052 | 2016-10-17 |
| 1578901930 | Illini Medical Associates, Sc | Durable Medical Equipment & Medical Supplies | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2013-06-07 |
| 1598036071 | Krista E Jenkins | Physician Assistant | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2012-01-16 |
| 1023259967 | Victoria Ann Hargrave | Registered Nurse | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2009-03-22 |
| 1205090644 | Colleen M Canavan | Physician Assistant | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2008-07-15 |
| 1215062914 | Cynthia Barrett | Clinical Nurse Specialist | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2007-02-22 |
| 1053345488 | Deborah Marie Seymour | Nurse Practitioner | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2006-07-10 |
| 1013965698 | Illini Medical Associates Sc | Clinic/Center | 390 Maple Summit Rd, Jerseyville, IL 62052-2000 | 2006-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396265666 | Lauren Mccarthy | Podiatrist | 400 Maple Summit Rd Suite 200, Jerseyville, IL 62052 | 2017-06-27 |
| 1851757488 | German Insurance Agency | Local Education Agency (LEA) | 850 S State Street, Jerseyville, IL 62052 | 2016-01-12 |
| 1942584230 | Thomas G Honke | Pharmacist | 705 South State, Walgreens, Jerseyville, IL 62052 | 2011-10-05 |
| 1861786493 | Pain Relief Center | Clinic/Center | 903 South State Street, Jerseyville, IL 62052 | 2011-05-31 |
| 1902058845 | Ronald Lee Schroeder | Obstetrics & Gynecology | 1211 West Carpenter, Jerseyville, IL 62052 | 2008-10-22 |
| 1760696116 | Rebecca Elaine Alexander | Massage Therapist | 1301 S State St, Jerseyville, IL 62052 | 2007-05-09 |
| 1205950540 | Charles C Alexander | Chiropractor | 1301 S State, Jerseyville, IL 62052 | 2007-03-19 |
| 1902816358 | Kirk William Schultz | Chiropractor | 519 South State Street, Jerseyville, IL 62052 | 2006-08-08 |
| 1235119652 | Batool N Vali | Obstetrics & Gynecology | 1702 W. County Road, Jerseyville, IL 62052 | 2006-01-20 |
| 1649270729 | Jersey County Health Department | Public Health or Welfare | 1307 State Highway 109, Jerseyville, IL 62052 | 2005-07-29 |
| Find all providers in zip 62052 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134163827 | Jersey Community Hospital | Clinic/Center | 400 Maple Summit Rd, Jerseyville, IL 62052-2028 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 | ||||
| City | JERSEYVILLE |
| Zip Code | 62052 |
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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.