NPIMap

Organization Active NPI

Bushnell Dix Hill Jones 694110

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Jacksonville, IL
National Provider Identifier
1154465243
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
BUSHNELL DIX HILL JONES 694110
Practice address
1201 S Main St
Jacksonville, IL 62650-3339
Phone
(217) 479-2120
Fax
(217) 243-8920
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Susie Pennell
Title
Administrative Asst
Phone
(217) 479-2120

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

1201 S Main St
Jacksonville, IL 62650-3339

Mailing address

1201 S Main St
Jacksonville, IL 62650-3339
Phone (217) 479-2120

Other identifiers 1

IdentifierTypeStateIssuer
694110MedicaidIL

Other names 1

  • Jacksonville Developmental Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Howe Center - Unit 4264292 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154465243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S MAIN ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503339",
            "telephone_number": "217-479-2120",
            "fax_number": "217-243-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S MAIN ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503339",
            "telephone_number": "217-479-2120",
            "fax_number": "217-243-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUSHNELL DIX HILL JONES 694110",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PENNELL",
        "authorized_official_first_name": "SUSIE",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASST",
        "authorized_official_telephone_number": "217-479-2120"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "694110",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacksonville Developmental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.