JOHNSTON CITY MEDICAL CLINIC, S. C. (NPI# 1962428516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962428516 |
| Entity Type | Organization |
| Organization Name | JOHNSTON CITY MEDICAL CLINIC, S. C. |
| Practice Address |
201 W Broadway Blvd Johnston City IL 62951-1427 |
| Mailing Address |
201 W Broadway Blvd P. O. Box 209 Johnston City IL 62951-1427 |
| Practice Telephone | 6189836911 |
| Practice Fax Number | 6189836913 |
| Mailing Telephone | 6189836911 |
| Mailing Fax Number | 6189836913 |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. KHALID JAVED (ADMINISTRATOR) |
| Authorized Official Telephone | 6189836911 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
IL | Ambulatory Health Care Facilities |
| Street Address |
201 W BROADWAY BLVD |
| City | JOHNSTON CITY |
| State | IL |
| Zip Code | 62951-1427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093230625 | Chrysalis Behavior Services | Behavioral Analyst | 13887 Jeffrey Mine Road, Johnston City, IL 62951 | 2017-08-04 |
| 1144454232 | Ashley Jean Byrley | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951 | 2009-05-05 |
| 1982888343 | Jamie Lynn Fred | Licensed Practical Nurse | 119 Gas Plant Road, Rea Clinic-duquoin, Johnston City, IL 62951 | 2007-12-20 |
| 1053593533 | Christopher Greater Area Rural Health Planning Corporation | Internal Medicine | 14410 Route 37, Johnston City Community Health Center, Johnston City, IL 62951 | 2007-11-27 |
| 1093166845 | Pathway House, Inc. | Assisted Living Facility | 806 W 10th St, Johnston City, IL 62951-1017 | 2016-06-23 |
| 1205907664 | Gary J Bandy | Pharmacist | 905 Grand Ave, Johnston City, IL 62951-1219 | 2006-11-09 |
| 1144355736 | Bandy Drugs | Pharmacy | 905 Grand Ave, Johnston City, IL 62951-1219 | 2007-02-22 |
| 1295020493 | Rachel Adrianne Pauls | Speech-Language Pathologist | 1108 Grand Ave, Johnston City, IL 62951-1229 | 2011-06-15 |
| 1356342331 | Christa S Pestka | Family Medicine | 14410 Route 37, Johnston City, IL 62951-1427 | 2005-08-02 |
| 1346363553 | Villa House, Inc | Exclusive Provider Organization | 1112 Washington Ave, Johnston City, IL 62951-1536 | 2007-04-10 |
| Find all providers in zip 62951 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| 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 | JOHNSTON CITY |
| Zip Code | 62951 |
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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.