NPIMap

Organization Active NPI

Dongola SCH Unit Dist 66

  • Student Health Clinic/Center
  • Dongola, IL
National Provider Identifier
1104096932
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
DONGOLA SCH UNIT DIST 66
Practice address
1000 High St.
Dongola, IL 62926-0190
Phone
(618) 827-3841
Fax
(618) 827-4641
NPI assigned
Mar 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Authorized official

Name
Mr. Brett Shawn Gayer, EDS
Title
Superintendent/Principal
Phone
(618) 827-3841

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X IL Primary

Addresses

Primary practice location

1000 High St.
Dongola, IL 62926-0190

Mailing address

PO Box 190
Dongola, IL 62926-0190
Phone (618) 827-3841

Other identifiers 1

IdentifierTypeStateIssuer
3760047396292601MedicaidIL

Other names 1

  • Dongola Sch Unit Dist 66 Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1104096932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "DONGOLA",
            "state": "IL",
            "postal_code": "629260190",
            "telephone_number": "618-827-3841",
            "fax_number": "618-827-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HIGH ST.",
            "city": "DONGOLA",
            "state": "IL",
            "postal_code": "629260190",
            "telephone_number": "618-827-3841",
            "fax_number": "618-827-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONGOLA SCH UNIT DIST 66",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "GAYER",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "SHAWN",
        "authorized_official_title_or_position": "SUPERINTENDENT/PRINCIPAL",
        "authorized_official_telephone_number": "618-827-3841",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "EDS"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3760047396292601",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dongola Sch Unit Dist 66",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dongola, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.