Vibra Hospital of Springfield LLC

Primary specialty

Long Term Care HospitalTaxonomy code 282E00000X

License

0005900 Issued in IL

Legal business name

VIBRA HOSPITAL OF SPRINGFIELD LLC

Doing business as

Vibra Hospital of Springfield

Practice address

701 N Walnut St
Springfield, IL 62702-4931

Phone

(217) 528-1217

Fax

(217) 528-1633

NPI assigned

May 9, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Clint T. Fegan

Title

Sec/Treas

Phone

(717) 591-5700

Specialties & licenses 1

Addresses

Other names 1

• Vibra Hospital of Springfield Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 140306

Legal name

THC - CHICAGO, INC D/B/A KINDRED HOSP SPRINGFIELD

Certification status

Terminated Other: provider status change, Aug 31, 2011

Provider type (POS)

Hospital – Short-term

Participating since

Feb 23, 2011

Last certification

Feb 23, 2011

Beds

50

Ownership / control type

Private (for profit)

Facility address

701 North Walnut Street
Springfield, IL 62702

Hospital certification: CCN 142014

Legal name

VIBRA HOSPITAL OF SPRINGFIELD

Certification status

Terminated Voluntary: merger or closure, Mar 5, 2019

Provider type (POS)

Hospital – Long-term

Participating since

Sep 1, 2011

Last certification

Jan 5, 2012

Beds

50

Ownership / control type

Private (for profit)

Most recent change of ownership

Sep 1, 2013 (3 total)

Facility address

701 N Walnut
Springfield, IL 62702

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545004800000",
    "number": "1083059539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8081 ROYAL RIDGE PARKWAY",
            "address_2": "SUITE 130",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632840",
            "telephone_number": "469-713-5470",
            "fax_number": "469-713-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N WALNUT ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024931",
            "telephone_number": "217-528-1217",
            "fax_number": "217-528-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRA HOSPITAL OF SPRINGFIELD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-09",
        "last_updated": "2018-12-17",
        "status": "A",
        "authorized_official_last_name": "FEGAN",
        "authorized_official_first_name": "CLINT",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "SEC/TREAS",
        "authorized_official_telephone_number": "717-591-5700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "IL",
            "license": "0005900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vibra Hospital of Springfield",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vibra Hospital of Springfield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Akshra Verma, MD, MS
• Sonam Verma, MD
• Elizabeth Verzo, MS RDN LDN FAND
• Sally A Vespa, P.A.-C.
• Robert H Viaille, MD
• Sandra K Vicari, LCPC, PH.D.
• Maria Jose Vides Sanchez, MD
• Julio Cesar Vijil Sr., MD
• Lydia Simeona Q Villafuerte, MD
• Namita Vinayek, MD

• Long Term Care Hospital in Springfield, IL
• Providers in Springfield, IL by specialty
• Long Term Care Hospital in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.