Carle West Physician Group Inc
Organization Active NPI Durable Medical Equipment & Medical Supplies · Bloomington, IL
NPI 1033866801 · NPPES record last updated Mar 2, 2022
Key facts
- NPI
- 1033866801
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- Legal business name
- CARLE WEST PHYSICIAN GROUP INC
- Practice address
- 1111 Trinity LN Ste 111
Bloomington, IL 61704-8112 - Phone
- (309) 663-6461
- NPI assigned
- Mar 2, 2022
- Organization subpart
- Yes
- Parent organization (as reported)
- THE CARLE FOUNDATION
Authorized official
- Name
- James C Leonard
- Title
- President
- Phone
- (217) 902-5291
Other NPIs with the same Medicare PAC ID 1
Member of 1
Practitioners 282
-
Ashraf Abdeljaber, M.D
-
Kelly J Abrams, NP
-
Brandon W. Ahlers, CRNA
-
Viquar U Ahmed, P.A.-C
-
Muhammad S Akhtar, M.D.
-
Saba Akram, MD
-
Kerrie Armstrong, PH.D.
-
Mukesh Arora, MD
-
Xiao-Tian Austin, MD
-
Aamir Banday, M.D.
-
Brian Robert Beeman, M.D.
-
Maria Bertsche, FNP
-
Nicole Bing, OT
-
Teresa Boyle, APRN
-
Robert A. Braastad, M.D.
-
Sherry Brendalen, LPC
-
Laura Browning, PA
-
John S. Burr, M.D.
-
Andrew Button, PA-C
-
Erin M Carmean, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220504001252 | IL | DME Supplier - Physician - Orthopedic/Orthopedic Surgery | 8921420308 | Practice locations: Bloomington, IL |
National Provider Directory
Locations
1111 Trinity Ln
Ste 111
Bloomington, IL 61704
Phone (309) 663-6461
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Yes |
Addresses
Primary practice location
1111 Trinity LN Ste 111
Bloomington, IL 61704-8112
Mailing address
3310 Fields South Dr
Fapc
Champaign, IL 61822-3741
Phone (217) 902-5291
Other names
- CARLE MCLEAN ORTHOPEDIC
Other providers in Bloomington, IL
- Carist LLC
- Braden James Carius
- Carle Clinic Association, PC
- Carle Foundation Hospital
- Carle Foundation Hospital
- Carley Nigro Counseling, PLLC
- Jennifer Marie Carlock
- Hadassah Carlson
- Michael John Carlson
- Leslie M. Carmack
All providers in Bloomington, IL · Durable Medical Equipment & Medical Supplies in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.