NPIMap

Organization Active NPI

Schuyler County Hospital District

Doing business as Community Medical Clinic of Table Grove

  • Rural Health Clinic/Center
  • Table Grove, IL
National Provider Identifier
1194223719
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SCHUYLER COUNTY HOSPITAL DISTRICT
Doing business as
Community Medical Clinic of Table Grove
Practice address
130 N Broadway St
Table Grove, IL 61482-9593
Phone
(309) 758-5070
NPI assigned
Jan 29, 2018
Last updated
Nov 9, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
SCHUYLER COUNTY HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Authorized official

Name
Tamra S Gadberry
Title
Cfo
Phone
(217) 322-5296

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

130 N Broadway St
Table Grove, IL 61482-9593

Mailing address

238 S Congress St
Rushville, IL 62681-1465

Other names 1

  • Community Medical Clinic of Table Grove Doing business as

National Provider Directory

National Provider Directory
Part of
Sarah D Culbertson Memorial

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

8460 Saint Lukes Dr
Beardstown, IL 62618
Phone (217) 323-2707

Practitioners & affiliated clinicians

Practitioners 112

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 112

NPI Registry JSON

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1194223719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 S CONGRESS ST",
            "city": "RUSHVILLE",
            "state": "IL",
            "postal_code": "626811465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N BROADWAY ST",
            "city": "TABLE GROVE",
            "state": "IL",
            "postal_code": "614829593",
            "telephone_number": "309-758-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHUYLER COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SCHUYLER COUNTY HOSPITAL DISTRICT",
        "enumeration_date": "2018-01-29",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A",
        "authorized_official_last_name": "GADBERRY",
        "authorized_official_first_name": "TAMRA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "217-322-5296"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Medical Clinic of Table Grove",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Table Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.