NPIMap

Organization Active NPI

Promise Healthcare at the Community Resource Center

  • Federally Qualified Health Center (FQHC)
  • Urbana, IL
National Provider Identifier
1174932586
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PROMISE HEALTHCARE AT THE COMMUNITY RESOURCE CENTER
Doing business as
Frances Nelson Health Center
Practice address
1400 W Park St
Building 3
Urbana, IL 61801
Phone
(217) 356-1558
NPI assigned
Aug 11, 2014
Organization subpart
Yes
Parent organization
PROMISE HEALTHCARE NFPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Authorized official

Name
Jennifer Henry
Title
Ceo
Phone
(217) 403-5401

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

1400 W Park St
Building 3
Urbana, IL 61801

Mailing address

819 Bloomington Rd
Champaign, IL 61820-2101
Phone (217) 356-1558

Other names 1

  • Frances Nelson Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Promise Healthcare NFP10 organizations share this tax ID, including this one
Part of
Promise Healthcare NFP

Other organizations with this tax ID 9

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

Locations

1400 W Park St
Bldg 3
Urbana, IL 61801
Phone (217) 356-1558

NPI Registry JSON

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1174932586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 BLOOMINGTON RD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618202101",
            "telephone_number": "217-356-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W PARK ST",
            "address_2": "BUILDING 3",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801",
            "telephone_number": "217-356-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMISE HEALTHCARE AT THE COMMUNITY RESOURCE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROMISE HEALTHCARE NFP",
        "enumeration_date": "2014-08-11",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-403-5401"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Frances Nelson Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Frances Nelson Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Urbana, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.