JULIA RACKLEY PERRY MEMORIAL HOSPITAL (NPI# 1821055039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821055039 |
| Entity Type | Organization |
| Organization Name | JULIA RACKLEY PERRY MEMORIAL HOSPITAL |
| Other Organization Name | PERRY MEMORIAL HOSPITAL |
| Practice Address |
530 Park Ave E Princeton IL 61356-3901 |
| Practice Telephone | 8158752811 |
| Practice Fax Number | 8158764455 |
| Mailing Telephone | 8158752811 |
| Mailing Fax Number | 8158764455 |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2020-03-06 |
| Authorized Official Name | JEAN WELTE (MEDICAL STAFF SERVICES COORDINATOR) |
| Authorized Official Telephone | 8158762293 |
| Is Organization Subpart | Y |
| Parent Organization Name | JULIA RACKLEY PERRY MEMORIAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 275N00000X | Medicare Defined Swing Bed Unit | 1883 | IL | Hospital Units |
| Other Name | Type Code |
|---|---|
| Perry Memorial Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932610110 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 530 Park Ave E Fl 3, Princeton, IL 61356-3901 | 2017-10-16 |
| 1578083051 | Julia Rackley Perry Memorial Hospital | Surgery | 530 Park Ave E Ste 205, Princeton, IL 61356-3902 | 2017-06-26 |
| 1629598602 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 327 Edward St, Henry, IL 61537-1539 | 2017-06-21 |
| 1033649967 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 105 N Main St Ste 1, Walnut, IL 61376-9707 | 2017-06-13 |
| 1124021308 | Julia Rackley Perry Memorial Hospital | General Acute Care Hospital | 530 Park Ave E, Princeton, IL 61356-3901 | 2005-05-23 |
| 1134695422 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 327 Edward St, Henry, IL 61537-1539 | 2018-10-15 |
| 1043786338 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 105 N Main St Ste 1, Walnut, IL 61376-9707 | 2018-10-15 |
| 1952877243 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 530 Park Ave E Ste 303, Princeton, IL 61356-3903 | 2018-10-15 |
| 1699229823 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 2128 N Main St, Princeton, IL 61356-9728 | 2016-08-04 |
| 1326408204 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 2128 N Main St, Princeton, IL 61356-9728 | 2016-03-04 |
| Street Address |
530 PARK AVE E |
| City | PRINCETON |
| State | IL |
| Zip Code | 61356-3901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124021308 | Julia Rackley Perry Memorial Hospital | General Acute Care Hospital | 530 Park Ave E, Princeton, IL 61356-3901 | 2005-05-23 |
| 1427529577 | Ashley Kannenberg | Dietitian, Registered | 530 Park Ave E, Princeton, IL 61356-2598 | 2018-12-16 |
| 1689126799 | Jo A Muller | Nurse Practitioner | 530 Park Ave E, Ste 207, Princeton, IL 61356-3901 | 2016-10-25 |
| 1578940524 | Jennifer Hoffman | Nurse Practitioner | 530 Park Ave E, Princeton, IL 61356-3901 | 2015-04-29 |
| 1114326956 | Ketan R Patel | Internal Medicine | 530 Park Ave E, Suite 101, Princeton, IL 61356-3901 | 2014-08-18 |
| 1922411602 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 530 Park Ave E, Princeton, IL 61356-3901 | 2014-06-10 |
| 1942551312 | Jenny Gaworski | Nurse Practitioner | 530 Park Ave E, Princeton, IL 61356-3901 | 2012-09-26 |
| 1619231719 | Victoria Jeannine Anderson | Physical Therapy Assistant | 530 Park Ave E, Princeton, IL 61356-2598 | 2012-07-03 |
| 1710241286 | Jacquelyn Johnson | Occupational Therapist | 530 Park Ave E, Princeton, IL 61356-3901 | 2012-06-29 |
| 1023372869 | Debra K Austin | Physical Therapist | 530 Park Ave E, Princeton, IL 61356-2598 | 2012-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548698558 | Shelley Gorenz | Counselor | 1009 S. Main St., Princeton, IL 61356 | 2013-10-30 |
| 1780016626 | Jennifer Phillips | Pharmacist | 610 N. Main St., Princeton, IL 61356 | 2013-08-02 |
| 1477848521 | Princeton Prompt Care LLC | Clinic/Center | 2128 North Main Street, Princeton, IL 61356 | 2011-06-16 |
| 1306014196 | Lifefit Physical Rehab, Ltd. | Clinic/Center | 1225 N. Sixth St., Princeton, IL 61356 | 2008-02-14 |
| 1568669778 | Hawthorne Inn Supportive Living Facility | Assisted Living Facility | 136 N. Sixth St., Princeton, IL 61356 | 2007-06-29 |
| 1720209240 | Michelle Lee Mortensen | Music Therapist | 816 S. First St., Princeton, IL 61356 | 2007-05-01 |
| 1073733465 | Jarred Allen Farrell | Chiropractor | 682 East Peru Street, Princeton, IL 61356 | 2007-04-26 |
| 1952488397 | Donald R Marion | Optometrist | 2 Park Avenue West, Princeton, IL 61356 | 2006-11-01 |
| 1427138247 | Bruce Waldo Shriver | Dentist | 422 E Peru St, Princeton, IL 61356 | 2006-10-16 |
| 1871689612 | Jason A Monroe | Dentist | 334 Backbone Rd East, Princeton, IL 61356 | 2006-10-05 |
| Find all providers in zip 61356 | ||||
| Taxonomy Code | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255541736 | Gibson General Hospital Swing Bed | Medicare Defined Swing Bed Unit | 1808 Sherman Dr, Princeton, IN 47670-1043 | 2007-05-23 |
| 1851486708 | Caldwell County Hospital Inc | Medicare Defined Swing Bed Unit | 101 Hospital Dr, Princeton, KY 42445 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316169949 | Alexian Brothers Medical Center | Medicare Defined Swing Bed Unit | 800 Biesterfield Rd Ste 605, Eberle Medical Office Building, Elk Grove Village, IL 60007-3362 | 2007-05-03 |
| 1902854623 | Cgh Medical Center | Medicare Defined Swing Bed Unit | 100 E Le Fevre Rd, Sterling, IL 61081-1278 | 2006-05-05 |
| 1336638915 | Valley West Community Hospital | Medicare Defined Swing Bed Unit | 1302 N Main St, Sandwich, IL 60548-2587 | 2018-05-09 |
| 1447747316 | St Josephs Hospital Breese of The Hospital Sisters of The Third Order | Medicare Defined Swing Bed Unit | 9515 Holy Cross Ln, Breese, IL 62230-3618 | 2018-04-17 |
| 1912404765 | Katherine Shaw Bethea Hospital | Medicare Defined Swing Bed Unit | 403 E 1st St, Dixon, IL 61021-3116 | 2018-04-09 |
| 1801212055 | Osf Healthcare System | Medicare Defined Swing Bed Unit | 1051 W South St, Kewanee, IL 61443-8354 | 2014-03-12 |
| 1639595036 | Southern Illinois Hospital Services | Medicare Defined Swing Bed Unit | 2 S Hospital Dr, Murphysboro, IL 62966-3333 | 2014-03-10 |
| 1295066983 | Advocate Health and Hospitals Corp. | Medicare Defined Swing Bed Unit | 101 S Major St, Eureka, IL 61530-1246 | 2010-01-20 |
| 1114199122 | Accuracy Urgent Care | Medicare Defined Swing Bed Unit | 805 W Deyoung St, Suite E, Marion, IL 62959-1604 | 2008-03-31 |
| 1174713440 | St Francis Hospital Sisters of The Third Order of St Francis | Medicare Defined Swing Bed Unit | 1215 Franciscan Dr, Box 1215, Litchfield, IL 62056-1778 | 2007-08-01 |
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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.