ST JOSEPH MEDICAL CENTER (NPI# 1902066400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902066400 |
| Entity Type | Organization |
| Organization Name | ST JOSEPH MEDICAL CENTER |
| Other Organization Name | ST JOSEPH MEDICAL CENTER OCCUPATIONAL HEALTH |
| Practice Address |
1505 Eastland Dr Suite 1000 Bloomington IL 61701-3534 |
| Practice Telephone | 3096554905 |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2008-07-29 |
| Authorized Official Name | KENNETH J NATZKE (CEO) |
| Authorized Official Telephone | 3096655870 |
| Is Organization Subpart | Y |
| Parent Organization Name | OSF HEALTHCARE SYSTEM |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 5715427 | 01 |
| Other Name | Type Code |
|---|---|
| ST JOSEPH MEDICAL CENTER OCCUPATIONAL HEALTH | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851330203 | St Joseph Medical Center | Home Health | 211 Landmark Dr, Suite D3, Normal, IL 61761-2160 | 2006-06-04 |
| 1871547414 | St Joseph Medical Center | Internal Medicine | 302 Saint Joseph Dr, Bloomington, IL 61701-3506 | 2006-05-19 |
| 1679012710 | St Joseph Medical Center | General Acute Care Hospital | 8441 State Highway 47, Suite 4300, Bryan, TX 77807-3207 | 2017-02-22 |
| 1336465004 | St Joseph Medical Center | General Acute Care Hospital | 1717 S J St, Tacoma, WA 98405-4933 | 2010-04-20 |
| 1174758346 | St Joseph Medical Center | Radiology | 407 E Vernon Ave, Normal, IL 61761-3813 | 2009-05-18 |
| 1659552859 | St Joseph Medical Center | Emergency Medicine | 2200 E Washington St, Bloomington, IL 61701-4364 | 2007-11-16 |
| 1881782878 | St Joseph Medical Center | Internal Medicine | 1505 Eastland Dr, Suite 110, Bloomington, IL 61701-3534 | 2006-10-11 |
| 1184732851 | St Joseph Medical Center | General Acute Care Hospital | 2200 E Washington St, Bloomington, IL 61701-4364 | 2006-08-25 |
| 1932148236 | St Joseph Medical Center | Skilled Nursing Facility | 2200 E Washington St, Bloomington, IL 61701-4364 | 2006-06-05 |
| 1619916806 | St Joseph Medical Center | General Acute Care Hospital | 2200 E Washington St, Bloomington, IL 61701-4364 | 2006-06-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST JOSEPH MEDICAL CENTER | 1717 S J St, Tacoma, WA 98405-4933 |
| Street Address |
1505 EASTLAND DR SUITE 1000 |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701-3534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336142017 | Yogesh K Agarwal | Internal Medicine | 1505 Eastland Dr, Ste 330, Bloomington, IL 61701-3534 | 2005-05-24 |
| 1073082384 | Caroline J Turner | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2018-11-15 |
| 1548755366 | Sunanda R Kale | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2018-06-25 |
| 1790294403 | Sarah Kneip | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2017-09-26 |
| 1760909626 | Hannah K Corley | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2017-08-23 |
| 1467827592 | Kelly Karr | Registered Nurse | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2015-12-01 |
| 1205219607 | Michele Krieger-johnsen | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-7905 | 2015-07-02 |
| 1326420563 | Fresenius Medical Care Normal, LLC | Clinic/Center | 1505 Eastland Dr, Medical Plaza Lower Level, Bloomington, IL 61701-3534 | 2015-06-24 |
| 1588068803 | Allison Vogel | Physician Assistant | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2014-10-15 |
| 1578964987 | Kristin N Wilkins | Clinical Nurse Specialist | 1505 Eastland Dr, Suite 320, Bloomington, IL 61701-3534 | 2014-09-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140964 | County of Mclean | Community/Behavioral Health | 200 W Front St, 1st Floor Sw, C/o 200 W Front St, Suite 400f, Bloomington, IL 61701 | 2019-05-22 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
| 1215396288 | Heidi Larsen | Social Worker | 902 S East St, Bloomington, IL 61701 | 2016-02-18 |
| 1558735126 | Andrea E. Andrews Counseling LLC | Counselor | 200 W. Monroe St., Ste 302 C, Bloomington, IL 61701 | 2015-11-19 |
| 1174924856 | Carole Hahn | Dietitian, Registered | 1406 Forrest St, Bloomington, IL 61701 | 2014-09-12 |
| 1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
| 1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
| 1922435114 | Smitha H Shivaprasad | Pharmacist | 2611 East Oakland Avenue, Bloomington, IL 61701 | 2013-10-02 |
| 1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
| Find all providers in zip 61701 | ||||
| Taxonomy Code | 2083X0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Occupational Medicine |
| Occupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environments of the workplace; and the health outcomes of environmental exposures. Practitioners in this field address the promotion of health in the work place, and the prevention and management of occupational and environmental injury, illness, and disability. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265746689 | Floyd Edward Thurston | Preventive Medicine | 3310 E Mulberry Ct, Bloomington, IN 47401-2425 | 2010-07-27 |
| 1023278207 | Dorothy J. Lenzi | Preventive Medicine | 301 N Curry Pike, Bloomington, IN 47404-2502 | 2008-06-11 |
| 1508048133 | Kirsten Marie Koos | Preventive Medicine | 8500 Normandale Lake Blvd, Bloomington, MN 55437-3813 | 2007-12-05 |
| 1881715290 | John Stewart Jacoby | Preventive Medicine | 600 W 98th St, Bloomington, MN 55420-4773 | 2007-04-03 |
| 1487675161 | Leslie Mathers IIi | Preventive Medicine | 1701 E College Ave, Bloomington, IL 61704-2101 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356816466 | Taylor Nicole Rich | Preventive Medicine | 2408 Hampshire Dr Apt 2, Champaign, IL 61820-1215 | 2018-10-05 |
| 1720517568 | Avrom Simon | Preventive Medicine | 128 S Aberdeen St Unit 5s, Chicago, IL 60607-1507 | 2017-06-06 |
| 1215332531 | Cheryl Culberson | Preventive Medicine | 350 Surryse Rd Ste 110, Lake Zurich, IL 60047-3217 | 2014-10-29 |
| 1497018493 | Brian Charles Svazas | Preventive Medicine | 211 Kenilworth Ave, Glen Ellyn, IL 60137-5324 | 2012-06-25 |
| 1205129764 | Zbigniev Durlak | Preventive Medicine | 9930 Stratford L, Palos Hills, IL 60465 | 2011-05-17 |
| 1609168657 | New Life Pentecostal Medical Clinic for The Uninsured Inc | Preventive Medicine | 183 N Schuyler Ave, Kankakee, IL 60901-3828 | 2011-05-10 |
| 1821305269 | Daniel Alexander Bakston | Preventive Medicine | 835 S. Wolcott Ave E-144, University of Illinois Medical Center, Chicago, IL 60612-4006 | 2010-09-07 |
| 1194951913 | Sonya Meyers | Preventive Medicine | 835 S Wolcott Ave # E144, Chicago, IL 60612-3748 | 2009-06-08 |
| 1073755021 | Afiz A. Taiwo, Md. Mph. S.c. | Preventive Medicine | 309 Pinehurst Dr, Palos Heights, IL 60463-2911 | 2009-04-06 |
| 1104077494 | William Dawson | Preventive Medicine | 700 Woodmere Ln, Glenview, IL 60025-4469 | 2008-10-04 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMINGTON |
| Zip Code | 61701 |
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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.