NPIMap

Organization Active NPI

Promise Healthcare NFP

  • Federally Qualified Health Center (FQHC)
  • Champaign, IL
National Provider Identifier
1043936438
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PROMISE HEALTHCARE NFP
Doing business as
FN on Neil St.
Practice address
821 S Neil St
Champaign, IL 61820-5205
Phone
(217) 356-1558
NPI assigned
Oct 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Authorized official

Name
April Arrasmith
Title
Billing Manager
Phone
(217) 403-5403

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

821 S Neil St
Champaign, IL 61820-5205

Mailing address

819 Bloomington Rd
Champaign, IL 61820-2101
Phone (217) 356-1558

Other names 1

  • FN on Neil St. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130219000476 IL Part B Supplier - Clinic/Group Practice 6103071345 Receives reassigned benefits from 54 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Urbana, IL; Rantoul, IL; Champaign, IL
O20221229001383 IL Part A Provider - Federally Qualified Health Center (FQHC) 6103071345 Practice locations: Champaign, IL

Federally qualified health center certification: CCN 781114

Legal name
PROMISE HEALTHCARE NFP
Doing business as
FN ON NEIL ST
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 19, 2023
Last certification
Jan 19, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 1, 2012 in IL
Enrollment address
821 S Neil St
Champaign, IL 61820-5205

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Promise Healthcare NFP10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

821 S Neil St
Champaign, IL 61820
Phone (217) 356-1558

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Brice Hutchcraft Individual Corporate DirectorBoard Member Sep 27, 2016
Kandace Turner Individual Corporate DirectorBoard Member Sep 25, 2018
Minnie Pearson Individual Corporate DirectorBoard Member Aug 6, 2012
Keith Flores Individual Corporate OfficerCfo Jan 15, 2024
Scott Greenlee Individual Corporate DirectorBoard Member Sep 25, 2018
Claudia Lennoff Individual Corporate DirectorBoard Member Aug 6, 2012
Robert Lewis Individual Corporate DirectorBoard Member Sep 22, 2020
Paulette Colemon-Peeples Individual Corporate DirectorBoard Member Sep 22, 2020
Pamela Bigler Individual Corporate DirectorBoard Member May 22, 2018
Joseph Guyette Individual Corporate DirectorBoard Member Sep 27, 2016
April Arrasmith Individual W-2 Managing EmployeeBilling Manager Oct 31, 2022
Jennifer Henry Individual Corporate OfficerExecutive Director Jul 1, 2021
W-2 Managing EmployeeExecutive Director Jul 1, 2021
Operational/Managerial ControlExecutive Director Jul 1, 2021

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1043936438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 BLOOMINGTON RD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618202101",
            "telephone_number": "217-356-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 S NEIL ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618205205",
            "telephone_number": "217-356-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMISE HEALTHCARE NFP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-11",
        "status": "A",
        "authorized_official_last_name": "ARRASMITH",
        "authorized_official_first_name": "APRIL",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "217-403-5403"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FN on Neil St.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.