NPIMap

Organization Active NPI

Central School District #104

  • Local Education Agency (LEA)
  • O Fallon, IL
National Provider Identifier
1043356678
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
Legal business name
CENTRAL SCHOOL DISTRICT #104
Practice address
309 Hartman LN
O Fallon, IL 62269-1725
Phone
(618) 632-6336
Fax
(618) 632-0870
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Steve Amizich
Title
Superintendent
Phone
(618) 632-6336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Local Education Agency (LEA) 251300000X Primary

Addresses

Primary practice location

309 Hartman LN
O Fallon, IL 62269-1725

Mailing address

309 Hartman LN
O Fallon, IL 62269-1725
Phone (618) 632-6336

National Provider Directory

National Provider Directory

Locations

309 Hartman Ln
O Fallon, IL 62269
Phone (618) 632-6336

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043356678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 HARTMAN LN",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691725",
            "telephone_number": "618-632-6336",
            "fax_number": "618-632-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 HARTMAN LN",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691725",
            "telephone_number": "618-632-6336",
            "fax_number": "618-632-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL SCHOOL DISTRICT #104",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AMIZICH",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "618-632-6336",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.