Organization Active NPI

Champaign Urbana Public Health District

  • Public Health or Welfare Agency
  • Champaign, IL
National Provider Identifier
1073666996
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
CHAMPAIGN URBANA PUBLIC HEALTH DISTRICT
Practice address
201 W Kenyon Rd
Champaign, IL 61820
Phone
(217) 532-7961
Fax
(217) 531-5382
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Julie A Pryde
Title
Executive Administrator
Phone
(217) 531-5369

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X IL Primary

Addresses

Primary practice location

201 W Kenyon Rd
Champaign, IL 61820

Mailing address

201 W Kenyon Rd
Champaign, IL 61820
Phone (217) 532-7961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040102000765 IL Part B Supplier - Mass Immunization (Roster Biller Only) 6002715653 Practice locations: Champaign, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1073666996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W KENYON RD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "61820",
            "telephone_number": "217-532-7961",
            "fax_number": "217-531-5382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W KENYON RD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "61820",
            "telephone_number": "217-532-7961",
            "fax_number": "217-531-5382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPAIGN URBANA PUBLIC HEALTH DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "PRYDE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATOR",
        "authorized_official_telephone_number": "217-531-5369"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.