NPIMap

Organization Active NPI

Desoto CCSD 86

  • Student Health Clinic/Center
  • De Soto, IL
National Provider Identifier
1225200850
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
DESOTO CCSD 86
Practice address
311 Hurst Rd
De Soto, IL 62924-1228
Phone
(618) 867-2317
Fax
(618) 867-3233
NPI assigned
Mar 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mr. Mark Edward Bullock
Title
Superintendent
Phone
(618) 867-2317

Specialties & licenses 1

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

Addresses

Primary practice location

311 Hurst Rd
De Soto, IL 62924-1228

Mailing address

311 Hurst Rd
De Soto, IL 62924-1228
Phone (618) 867-2317

Other names 1

  • DeSoto Cons School Districxt 86 Other name

National Provider Directory

National Provider Directory
Tax ID family
Desoto CCSD 862 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

311 Hurst Rd
De Soto, IL 62924
Phone (618) 867-2317

NPI Registry JSON

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1225200850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 HURST RD",
            "city": "DE SOTO",
            "state": "IL",
            "postal_code": "629241228",
            "telephone_number": "618-867-2317",
            "fax_number": "618-867-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 HURST RD",
            "city": "DE SOTO",
            "state": "IL",
            "postal_code": "629241228",
            "telephone_number": "618-867-2317",
            "fax_number": "618-867-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESOTO CCSD 86",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "618-867-2317",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeSoto Cons School Districxt 86",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in De Soto, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.