NPIMap

Organization Active NPI

Carbondale Elem SCH Dist 95

  • Student Health Clinic/Center
  • Carbondale, IL
National Provider Identifier
1225156144
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
CARBONDALE ELEM SCH DIST 95
Practice address
925 S Giant City Rd
Carbondale, IL 62902-5056
Phone
(618) 457-3591
Fax
(618) 457-2043
NPI assigned
Mar 27, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. John K Williams, SPECIALIST
Title
Assistant Superintendent
Phone
(618) 457-3591

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X IL Primary

Addresses

Primary practice location

925 S Giant City Rd
Carbondale, IL 62902-5056

Mailing address

925 S Giant City Rd
Carbondale, IL 62902-5056
Phone (618) 457-3591

Other names 1

  • Carbondale Elem School Other name

National Provider Directory

National Provider Directory
Tax ID family
Carbondale Elem SCH Dist 952 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1150 E Grand Ave
Ste 2
Carbondale, IL 62901

925 S Giant City Rd
Carbondale, IL 62902
Phone (618) 457-3591

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225156144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 S GIANT CITY RD",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629025056",
            "telephone_number": "618-457-3591",
            "fax_number": "618-457-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 S GIANT CITY RD",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629025056",
            "telephone_number": "618-457-3591",
            "fax_number": "618-457-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARBONDALE ELEM SCH DIST 95",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "ASSISTANT SUPERINTENDENT",
        "authorized_official_telephone_number": "618-457-3591",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "SPECIALIST"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carbondale Elem School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Carbondale, IL

Sources for this page

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