NPIMap

Organization Active NPI

Agesmart Community Resources

  • Voluntary or Charitable Agency
  • Belleville, IL
National Provider Identifier
1043687148
Registry record updated Aug 25, 2015
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Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
Legal business name
AGESMART COMMUNITY RESOURCES
Practice address
2365 Country Rd
Belleville, IL 62221-2571
Phone
(618) 222-2561
Fax
(618) 222-2567
NPI assigned
Aug 25, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Authorized official

Name
Joy Paeth
Title
Chief Executive Officer
Phone
(618) 222-2561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X Primary

Addresses

Primary practice location

2365 Country Rd
Belleville, IL 62221-2571

Mailing address

2365 Country Rd
Belleville, IL 62221-2571
Phone (618) 222-2561

Other names 1

  • Area Agency on Aging of Southwestern Illinois Former legal business name

National Provider Directory

National Provider Directory

Locations

2365 Country Rd
Belleville, IL 62221
Phone (618) 222-2561

NPI Registry JSON

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440460800000",
    "number": "1043687148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 COUNTRY RD",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622212571",
            "telephone_number": "618-222-2561",
            "fax_number": "618-222-2567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 COUNTRY RD",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622212571",
            "telephone_number": "618-222-2561",
            "fax_number": "618-222-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGESMART COMMUNITY RESOURCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-25",
        "last_updated": "2015-08-25",
        "status": "A",
        "authorized_official_last_name": "PAETH",
        "authorized_official_first_name": "JOY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "618-222-2561"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Area Agency on Aging of Southwestern Illinois",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; 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.