NPIMap

Organization Active NPI

Red Bud Clinic Corp

  • Family Medicine Physician
  • Red Bud, IL
National Provider Identifier
1083617609
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RED BUD CLINIC CORP
Practice address
325 Spring St
Red Bud, IL 62278-1105
Phone
(618) 282-3831
Fax
(618) 282-6101
NPI assigned
May 27, 2005
Last updated
Jul 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Authorized official

Name
Laura J Fey
Title
Sr. Director Physician Rev Cycle
Phone
(615) 221-3641

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

325 Spring St
Red Bud, IL 62278-1105

Mailing address

325 Spring St
Red Bud, IL 62278-1105
Phone (618) 282-3831

National Provider Directory

National Provider Directory

Locations

1000 Eleven S
Ste E
Columbia, IL 62236
Phone (618) 281-2273

325 Spring St
Fl 1
Red Bud, IL 62278
Phone (618) 282-5270

415 W South 4th St
Ste C
Red Bud, IL 62278
Phone (618) 282-7373

415 W South 4th St
Ste D
Red Bud, IL 62278
Phone (618) 282-7777

1408 Sparta Centre Dr
Sparta, IL 62286
Phone (618) 317-9302

1319 Jamie Ln
Bldg B
Waterloo, IL 62298
Phone (618) 939-1560

1335 Jamie Ln
Waterloo, IL 62298
Phone (618) 939-1560

723 Station Xing
Waterloo, IL 62298
Phone (618) 939-1551

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1083617609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 SPRING ST",
            "city": "RED BUD",
            "state": "IL",
            "postal_code": "622781105",
            "telephone_number": "618-282-3831",
            "fax_number": "618-282-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 SPRING ST",
            "city": "RED BUD",
            "state": "IL",
            "postal_code": "622781105",
            "telephone_number": "618-282-3831",
            "fax_number": "618-282-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED BUD CLINIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A",
        "authorized_official_last_name": "FEY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SR. DIRECTOR PHYSICIAN REV CYCLE",
        "authorized_official_telephone_number": "615-221-3641"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bud, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.