Carle West Physician Group Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CARLE WEST PHYSICIAN GROUP INC

Doing business as

Carle McLean Orthopedic

Practice address

1111 Trinity LN Ste 111
Bloomington, IL 61704-8112

Phone

(309) 663-6461

NPI assigned

Mar 2, 2022

Last updated

Mar 2, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

THE CARLE FOUNDATIONAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

James C Leonard

Title

President

Phone

(217) 902-5291

Specialties & licenses 1

Addresses

Other names 1

• CARLE MCLEAN ORTHOPEDIC Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Carle West Physician Group Inc

  • Family Medicine Physician
  • Normal, IL
  • NPI 1467074138

  8921420308

  Same PAC ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Carle Health Care Incorporated

  dba Carle Physician Group

  • Durable Medical Equipment & Medical Supplies
  • Effingham, IL
  • NPI 1366765786

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1033866801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 FIELDS SOUTH DR",
            "address_2": "FAPC",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618223741",
            "telephone_number": "217-902-5291",
            "fax_number": "217-902-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 TRINITY LN STE 111",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617048112",
            "telephone_number": "309-663-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLE WEST PHYSICIAN GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE CARLE FOUNDATION",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-902-5291"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CARLE MCLEAN ORTHOPEDIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carist LLC
• Braden James Carius, PA
• Carle Clinic Association, PC
• Carle Foundation Hospital (Carle RX Express)
• Carle Foundation Hospital (Carle Therapy Services)
• Carley Nigro Counseling, PLLC
• Jennifer Marie Carlock, LCSW
• Hadassah Carlson, LCPC
• Michael John Carlson
• Leslie M. Carmack, A.P.N.

• Durable Medical Equipment & Medical Supplies in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.