NPIMap

Organization Active NPI

Springfield Clinic Macomb Lab

  • Clinical Medical Laboratory
  • Macomb, IL
National Provider Identifier
1154719177
Registry record updated Jul 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
14D0702013 Issued in IL
Legal business name
SPRINGFIELD CLINIC MACOMB LAB
Practice address
505 E Grant St
Macomb, IL 61455-3394
Phone
(309) 833-1733
NPI assigned
Dec 29, 2014
Last updated
Jul 26, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
SPRINGFIELD CLINIC, LLPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 26, 2017

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

Authorized official

Name
Mr. Alan Nerone
Title
Senior Vice President & Cfo
Phone
(217) 528-7541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 14D0702013 IL Primary

Addresses

Primary practice location

505 E Grant St
Macomb, IL 61455-3394

Mailing address

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

Other identifiers 1

IdentifierTypeStateIssuer
14D0702013OtherILCLIA

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0702013Springfield Clinic - Macomb505 E Grant St, Macomb, IL 61455Certificate of waiverJul 21, 2028

National Provider Directory

National Provider Directory
Tax ID family
Taylorville Medical Associates Lab63 organizations share this tax ID, including this one
Part of
Taylorville Medical Associates Lab

Organizations with this tax ID in the same state 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1419811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501027200000",
    "number": "1154719177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E GRANT ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614553394",
            "telephone_number": "309-833-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGFIELD CLINIC MACOMB LAB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPRINGFIELD CLINIC, LLP",
        "enumeration_date": "2014-12-29",
        "last_updated": "2017-07-26",
        "status": "A",
        "authorized_official_last_name": "NERONE",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT & CFO",
        "authorized_official_telephone_number": "217-528-7541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": "14D0702013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "14D0702013",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.