NPIMap

Organization Active NPI

Pioneer Concepts, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Galesburg, IL
National Provider Identifier
1053776930
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
201300003S Issued in IL
Legal business name
PIONEER CONCEPTS, INC.
Practice address
285 S Farnham St
Galesburg, IL 61401-5323
Phone
(309) 343-1550
NPI assigned
Dec 21, 2015
Last updated
Dec 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2015

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

Authorized official

Name
Mr. Ronald J Wilson
Title
Authorized Agent
Phone
(309) 343-1550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 201300003S IL Primary

Addresses

Primary practice location

285 S Farnham St
Galesburg, IL 61401-5323

Mailing address

285 S Farnham St
Galesburg, IL 61401-5323
Phone (309) 343-1550

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D1107282Pioneer Concepts Inc285 S Farnham St, Galesburg, IL 61401Certificate of waiverNov 1, 2027

National Provider Directory

National Provider Directory
Tax ID family
Pioneer Concepts Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Ownership & related parties

Subparts reporting this organization as parent 11

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450656000000",
    "number": "1053776930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 S FARNHAM ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614015323",
            "telephone_number": "309-343-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 S FARNHAM ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614015323",
            "telephone_number": "309-343-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER CONCEPTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-21",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "AUTHORIZED AGENT",
        "authorized_official_telephone_number": "309-343-1550",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": "201300003S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.