NPIMap

Organization Active NPI

Epic, Inc.

  • Case Management Agency
  • Peoria, IL
National Provider Identifier
1073643474
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
EPIC, INC.
Practice address
1913 W Townline Rd
Peoria, IL 61615-1621
Phone
(309) 691-3800
Fax
(309) 689-3613
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

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

Authorized official

Name
Julia Kim Cornwell
Title
Ceo
Phone
(309) 691-3800

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary
Developmentally Disabled Services Day Training Agency 251C00000X IL
Community/Behavioral Health Agency 251S00000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X IL

Addresses

Primary practice location

1913 W Townline Rd
Peoria, IL 61615-1621

Mailing address

PO Box 3418
1913 Townline Road
Peoria, IL 61612-3418
Phone (309) 691-3800

National Provider Directory

National Provider Directory
Tax ID family
Epic Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464739200000",
    "number": "1073643474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3418",
            "address_2": "1913 TOWNLINE ROAD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616123418",
            "telephone_number": "309-691-3800",
            "fax_number": "309-689-3613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1913 W TOWNLINE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151621",
            "telephone_number": "309-691-3800",
            "fax_number": "309-689-3613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2016-06-01",
        "status": "A",
        "authorized_official_last_name": "CORNWELL",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "KIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-691-3800"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; 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.