NPIMap

Organization Active NPI

Julia Rackley Perry Memorial Hospital

Doing business as Perry Memorial Walnut Clinic

  • Rural Health Clinic/Center
  • Walnut, IL
National Provider Identifier
1043786338
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
JULIA RACKLEY PERRY MEMORIAL HOSPITAL
Doing business as
Perry Memorial Walnut Clinic
Practice address
105 N Main St Ste 1
Walnut, IL 61376-9707
Phone
(815) 379-2020
Fax
(815) 379-2018
NPI assigned
Oct 15, 2018
Last updated
Jun 15, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
JULIA RACKLEY PERRY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Authorized official

Name
Jean Welte
Title
Medical Staff Services Coordinator
Phone
(815) 876-2293

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

105 N Main St Ste 1
Walnut, IL 61376-9707

Mailing address

530 Park Ave E
Princeton, IL 61356-3901
Phone (815) 876-4419

Other names 1

  • Perry Memorial Walnut Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Julia Rackley Perry Memorial Hospital5 organizations share this tax ID, including this one
Part of
Julia Rackley Perry Memorial Hospital

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592179200000",
    "number": "1043786338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 PARK AVE E",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613563901",
            "telephone_number": "815-876-4419",
            "fax_number": "815-876-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N MAIN ST STE 1",
            "city": "WALNUT",
            "state": "IL",
            "postal_code": "613769707",
            "telephone_number": "815-379-2020",
            "fax_number": "815-379-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIA RACKLEY PERRY MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JULIA RACKLEY PERRY MEMORIAL HOSPITAL",
        "enumeration_date": "2018-10-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A",
        "authorized_official_last_name": "WELTE",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "MEDICAL STAFF SERVICES COORDINATOR",
        "authorized_official_telephone_number": "815-876-2293"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perry Memorial Walnut Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Perry Memorial Walnut Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walnut, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.