NPIMap

Organization Active NPI

Graham Hospital Association

  • Durable Medical Equipment & Medical Supplies
  • Canton, IL
National Provider Identifier
1114938859
Registry record updated Oct 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
203000310 Issued in IL
Legal business name
GRAHAM HOSPITAL ASSOCIATION
Practice address
101 S Main St
Canton, IL 61520-2607
Phone
(309) 647-5240
Fax
(309) 649-5110
NPI assigned
Aug 10, 2006
Last updated
Oct 19, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2017

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

Authorized official

Name
Julie Reeder
Title
VP of Finance/Cfo
Phone
(309) 647-5240

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 203000310 IL Primary

Addresses

Primary practice location

101 S Main St
Canton, IL 61520-2607

Mailing address

101 S Main St
Canton, IL 61520-2607
Phone (309) 647-5240

Other identifiers 2

IdentifierTypeStateIssuer
016564OtherILHEALTH ALLIANCE
0002915611OtherILBLUE CROSS BLUE SHIELD IL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930002134 IL DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 2769375021 Practice locations: Canton, IL

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Graham Hospital Association101 S Main St, Canton, IL 61520-2607(309) 647-5240 Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Contracture Treatment Devices: Dynamic Splint|Blood Glucose Monitors/Supplies (Non-Mail Order)|Gastric Suction Pumps|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|Infrared Heating Pads Systems and/or Suppl… Accepts assignmentParticipating since Jan 1, 1989

National Provider Directory

National Provider Directory
Tax ID family
Graham Hospital22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508371200000",
    "number": "1114938859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202607",
            "telephone_number": "309-647-5240",
            "fax_number": "309-649-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202607",
            "telephone_number": "309-647-5240",
            "fax_number": "309-649-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAHAM HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2017-10-19",
        "status": "A",
        "authorized_official_last_name": "REEDER",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "VP OF FINANCE/CFO",
        "authorized_official_telephone_number": "309-647-5240"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "203000310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "016564",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "0002915611",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.