NPIMap

Organization Active NPI

Pana Community Hospital Association

Doing business as Community Medical Clinic of Nokomis

  • Family Medicine Physician
  • Nokomis, IL
National Provider Identifier
1114388733
Registry record updated Mar 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PANA COMMUNITY HOSPITAL ASSOCIATION
Doing business as
Community Medical Clinic of Nokomis
Practice address
120 S Cedar St
Nokomis, IL 62075-1647
Phone
(217) 563-8363
Fax
(217) 563-8373
NPI assigned
Mar 9, 2016
Last updated
Mar 9, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY MEDICAL CLINIC OF NOKOMISAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 9, 2016

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

Authorized official

Name
Lisa Bloemer
Title
Practice Manager
Phone
(217) 562-6246

Specialties & licenses 1

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

Addresses

Primary practice location

120 S Cedar St
Nokomis, IL 62075-1647

Mailing address

120 S Cedar St
Nokomis, IL 62075-1647
Phone (217) 563-8363

Other names 1

  • Community Medical Clinic of Nokomis Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pana Comm Hosp Respirat17 organizations share this tax ID, including this one
Part of
Pana Comm Hosp Respirat

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1457481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457481600000",
    "number": "1114388733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S CEDAR ST",
            "city": "NOKOMIS",
            "state": "IL",
            "postal_code": "620751647",
            "telephone_number": "217-563-8363",
            "fax_number": "217-563-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S CEDAR ST",
            "city": "NOKOMIS",
            "state": "IL",
            "postal_code": "620751647",
            "telephone_number": "217-563-8363",
            "fax_number": "217-563-8373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANA COMMUNITY HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY MEDICAL CLINIC OF NOKOMIS",
        "enumeration_date": "2016-03-09",
        "last_updated": "2016-03-09",
        "status": "A",
        "authorized_official_last_name": "BLOEMER",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "217-562-6246"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Medical Clinic of Nokomis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nokomis, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; 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.