Monclair Enterprises, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MONCLAIR ENTERPRISES, INC.

Practice address

1000 Eleven S Ste 2B
Columbia, IL 62236-1079

Phone

(618) 281-7010

Fax

(949) 543-2846

NPI assigned

Jan 31, 2019

Organization subpart

No

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

Authorized official

Name

Tami Boren, FNP-CNPI 1962804294

Title

Owner/President

Phone

(618) 281-7010

Specialties & licenses 1

Addresses

Other names 1

• MonClair Family Practice Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tami Boren, FNP - C

  • Family Nurse Practitioner
  • Columbia, IL
  • NPI 1962804294
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719100800000",
    "number": "1043774342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ELEVEN S STE 2B",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622361079",
            "telephone_number": "618-281-7010",
            "fax_number": "618-281-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ELEVEN S STE 2B",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622361079",
            "telephone_number": "618-281-7010",
            "fax_number": "949-543-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONCLAIR ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-31",
        "last_updated": "2024-06-23",
        "certification_date": "2024-06-23",
        "status": "A",
        "authorized_official_last_name": "BOREN",
        "authorized_official_first_name": "TAMI",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "618-281-7010",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MonClair Family Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MonClair Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Mary Miles, LCSW
• Malissa Miller, NURSE PRACTITIONER
• Wendy J Missey, MS RD LDN
• Mitan Pediatric Therapy Inc
• Robin Mitan, OT
• Stephanie Lynn Morris, MSCCC/SLP
• Susan K Morris, PT
• Msa Alliance, LLC
• Katelyn F Mushinsky, MS CCC-SLP
• Nathan D. Williamson, D.M.D. LLC

• Family Medicine Physician in Columbia, IL
• Providers in Columbia, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.