NPIMap

Organization Active NPI

Egyptian Area Agency on Aging, Inc

  • Case Management Agency
  • Carterville, IL
National Provider Identifier
1083083786
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
EGYPTIAN AREA AGENCY ON AGING, INC
Practice address
200 E Plaza Dr
Carterville, IL 62918-1982
Phone
(618) 985-8311
Fax
(618) 985-8315
NPI assigned
Sep 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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

Authorized official

Name
John M Smith
Title
Executive Director
Phone
(618) 985-8311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

200 E Plaza Dr
Carterville, IL 62918-1982

Mailing address

200 E Plaza Dr
Carterville, IL 62918-1982
Phone (618) 985-8311

National Provider Directory

National Provider Directory

Locations

200 E Plaza Dr
Carterville, IL 62918
Phone (618) 985-8311

Practitioners & affiliated clinicians

Practitioners 1

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": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1083083786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E PLAZA DR",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629181982",
            "telephone_number": "618-985-8311",
            "fax_number": "618-985-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E PLAZA DR",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629181982",
            "telephone_number": "618-985-8311",
            "fax_number": "618-985-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EGYPTIAN AREA AGENCY ON AGING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-985-8311"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carterville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.