NPIMap

Organization Active NPI

Solvera Healthcare Center Inc

  • Clinic Pharmacy
  • Peoria, IL
National Provider Identifier
1164099198
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
SOLVERA HEALTHCARE CENTER INC
Practice address
3525 N University St
Peoria, IL 61604-1324
Phone
(309) 886-9172
NPI assigned
Jun 8, 2021
Organization subpart
Yes
Parent organization
SOLVERA HEALTHCARE CENTER INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Patrick Caplis
Title
Ceo
Phone
(309) 886-9172

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

3525 N University St
Peoria, IL 61604-1324

Mailing address

PO Box 9727
Peoria, IL 61612-9727
Phone (309) 886-9172

Other names 1

  • Solvera Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211011003159 IL Part B Supplier - Pharmacy 4981007226 1 other NPI on this enrollment
Practice locations: Galesburg, IL; Peoria, IL

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Solvera Healthcare Center3 organizations share this tax ID, including this one
Part of
Solvera Healthcare Center

Other organizations with this tax ID 2

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

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Solvera HealthPeoria, IL, CCN C41023 Federally qualified health center Other (100%) Mar 22, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1164099198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9727",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616129727",
            "telephone_number": "309-886-9172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 N UNIVERSITY ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616041324",
            "telephone_number": "309-886-9172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLVERA HEALTHCARE CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOLVERA HEALTHCARE CENTER INC.",
        "enumeration_date": "2021-06-08",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "CAPLIS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-886-9172"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Solvera Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.