Health Plan of Southern Illinois, Inc.

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

HEALTH PLAN OF SOUTHERN ILLINOIS, INC.

Doing business as

Franklin Rural Health Clinic I

Practice address

205 Bailey LN
Benton, IL 62812-1921

Phone

(618) 439-3706

Fax

(618) 435-2023

NPI assigned

Oct 13, 2005

Last updated

Jan 23, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James Durham, M.D.

Title

Medical Director

Phone

(618) 439-3706

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Franklin Rural Health Clinic I Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232668800000",
    "number": "1215925102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BAILEY LN",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121921",
            "telephone_number": "618-439-3706",
            "fax_number": "618-435-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BAILEY LN",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121921",
            "telephone_number": "618-439-3706",
            "fax_number": "618-435-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH PLAN OF SOUTHERN ILLINOIS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-13",
        "last_updated": "2009-01-23",
        "status": "A",
        "authorized_official_last_name": "DURHAM",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "618-439-3706",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2815503",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Franklin Rural Health Clinic I",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Hancock, BS, MHP
• Brian Harrison, MD
• John D Hartman, MD
• Anthony Haskins
• Alexys Hayes
• Helia Healthcare of Benton
• Helia Healthcare of Benton, LLC
• Heritage Woods of Benton
• Highland Park CVS, L.L.C. (CVS Pharmacy 06372)
• Samantha Hilmers, MSW, LCSW

• Rural Health Clinic/Center in Benton, IL
• Providers in Benton, IL by specialty
• Rural Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.