St Marys Hospital

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

036070970 Issued in IL

Legal business name

ST MARYS HOSPITAL

Doing business as

St Marys Orthopedics

Practice address

104 W 6TH St
Streator, IL 61364-2899

Phone

(815) 673-3223

Fax

(815) 673-3305

NPI assigned

Oct 7, 2008

Organization subpart

Yes

Parent organization

ST MARYS HOSPITALAs reported in NPPES

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

Authorized official

Name

Karen S Clark

Title

Cfo

Phone

(815) 673-4514

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• St Marys Orthopedics Doing business as

Part of

St Mary'S Hospital Streator Hospital Sisters of the 3Rd Order St Fran

Practitioners 2

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

• Forrest Scot Rubenstein, M.D.

  • Vascular Surgery Physician
  • Port St Lucie, FL
  • NPI 1548281926
  NPD (past)
• John M Speca, M.D.

  • Orthopaedic Surgery Physician
  • Clarksdale, MS
  • NPI 1659330090
  NPD (past)

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240358400000",
    "number": "1164673307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W 6TH ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642899",
            "telephone_number": "815-673-3223",
            "fax_number": "815-673-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 6TH ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642899",
            "telephone_number": "815-673-3223",
            "fax_number": "815-673-3305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARYS HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST MARYS HOSPITAL",
        "enumeration_date": "2008-10-07",
        "last_updated": "2009-04-22",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "815-673-4514"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036070970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD NPI",
            "identifier": "1659330090",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9924600",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036070970",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "1164673307",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Marys Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Upendra K Sinha, MD
• Calvin Slot, MD
• Bruce Sylvester Smith, M.D.
• Emily K Snow, FNP-C
• John Sorensen, RPH
• St Marys Hospital
• St Marys Hospital Streator Hospital Sisters of the 3Rd Ordr St Francis
• St Marys Hospital Streator Hospital Sisters of the 3Rd Ordr St Francis
• St. Margaret'S Health-Peru
• St. Mary'S Hospital

• Orthopaedic Surgery Physician in Streator, IL
• Providers in Streator, IL by specialty
• Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2009; 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.