NATIONAL HEALTHCARE OF MT VERNON INC (NPI# 1932450772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932450772 |
| Entity Type | Organization |
| Organization Name | NATIONAL HEALTHCARE OF MT VERNON INC |
| Other Organization Name | CROSSROADS FAMILY MEDICINE OF WAYNE CITY |
| Practice Address |
1209 W Robinson St Wayne City IL 62895-9672 |
| Mailing Address |
Po Box 689022 Franklin TN 37068-9022 |
| Practice Telephone | 6188952050 |
| Practice Fax Number | 6188952056 |
| Mailing Telephone | 8007097338 |
| Mailing Fax Number | 6154696505 |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2020-08-11 |
| Authorized Official Name | RANDY MICHAEL COOPER (SVP FINANCE OP/AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 6152213840 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
0003947 | IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Crossroads Family Medicine of Wayne City | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902143910 | National Healthcare of Mt Vernon Inc | Internal Medicine | 905 W Washington St, Suite A, Benton, IL 62812-1649 | 2013-01-10 |
| 1982955712 | National Healthcare of Mt Vernon Inc | Clinic/Center | 905 W Washington St Ste A, Benton, IL 62812 | 2012-09-19 |
| 1447814405 | National Healthcare of Mt Vernon Inc | Clinic/Center | 4101 N Water Tower Pl, Mount Vernon, IL 62864-6296 | 2019-04-25 |
| 1528305448 | National Healthcare of Mt Vernon Inc | Family Medicine | 1209 W Robinson St, Wayne City, IL 62895-9672 | 2013-01-11 |
| 1619214624 | National Healthcare of Mt Vernon Inc | Internal Medicine | 209 Crossroads Pl, Suite 120, Mount Vernon, IL 62864-6545 | 2013-01-10 |
| 1962753277 | National Healthcare of Mt Vernon Inc | Clinic/Center | 209 Crossroads Pl, Suite 120, Mount Vernon, IL 62864-6545 | 2012-09-26 |
| 1063630820 | National Healthcare of Mt Vernon Inc | Emergency Medicine | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 | 2007-04-24 |
| 1750353041 | National Healthcare of Mt Vernon Inc | General Acute Care Hospital | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 | 2006-02-02 |
| 1851363154 | National Healthcare of Mt Vernon Inc | Medicare Defined Swing Bed Unit | 8 Doctors Park Rd, Mount Vernon, IL 62864-6224 | 2006-02-02 |
| Street Address |
1209 W ROBINSON ST |
| City | WAYNE CITY |
| State | IL |
| Zip Code | 62895-9672 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972597060 | Crossroads Physician Corp | Physician Assistant | 1209 W Robinson St, Wayne City, IL 62895-9672 | 2005-09-06 |
| 1528305448 | National Healthcare of Mt Vernon Inc | Family Medicine | 1209 W Robinson St, Wayne City, IL 62895-9672 | 2013-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437556800 | Stella C Johnson | Registered Nurse | 1601 West Robinson, Wayne City, IL 62895 | 2014-12-01 |
| 1326315318 | Kassi Dawn Mccormick | Physical Therapy Assistant | Rural Route Box 270a, Wayne City, IL 62895 | 2011-11-19 |
| 1770797706 | Wayne City Community School District 100 | Local Education Agency (LEA) | 302 Mill Street, Wayne City, IL 62895 | 2007-05-09 |
| 1750436002 | Village of Wayne City | Ambulance | 103 Mill Street, Wayne City, IL 62895-0176 | 2007-01-25 |
| 1083793962 | Bandys Apothecary Shops Inc | Pharmacy | 310 S Main St, Wayne City, IL 62895-0308 | 2006-11-03 |
| 1477554228 | Lisa K Feather | Physician Assistant | 1601 W Robinson, Wayne City, IL 62895-9483 | 2005-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437556800 | Stella C Johnson | Registered Nurse | 1601 West Robinson, Wayne City, IL 62895 | 2014-12-01 |
| 1326315318 | Kassi Dawn Mccormick | Physical Therapy Assistant | Rural Route Box 270a, Wayne City, IL 62895 | 2011-11-19 |
| 1770797706 | Wayne City Community School District 100 | Local Education Agency (LEA) | 302 Mill Street, Wayne City, IL 62895 | 2007-05-09 |
| 1750436002 | Village of Wayne City | Ambulance | 103 Mill Street, Wayne City, IL 62895-0176 | 2007-01-25 |
| 1477554228 | Lisa K Feather | Physician Assistant | 1601 W Robinson, Wayne City, IL 62895-9483 | 2005-08-02 |
| 1083793962 | Bandys Apothecary Shops Inc | Pharmacy | 310 S Main St, Wayne City, IL 62895-0308 | 2006-11-03 |
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
| City | WAYNE CITY |
| Zip Code | 62895 |
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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.