NPIMap

Organization Active NPI

Taylorville Medical Associates Lab

  • Clinical Medical Laboratory
  • Taylorville, IL
National Provider Identifier
1245498104
Registry record updated Aug 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
TAYLORVILLE MEDICAL ASSOCIATES LAB
Practice address
303 E Bidwell St
Taylorville, IL 62568-1363
Phone
(217) 824-4939
NPI assigned
May 28, 2008
Last updated
Aug 1, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
SPRINGFIELD CLINIC LLPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 1, 2008

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

Authorized official

Name
Mr. Randall A Bryant
Title
Cfo
Phone
(217) 528-7541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

303 E Bidwell St
Taylorville, IL 62568-1363

Mailing address

303 E Bidwell St
Taylorville, IL 62568-1363
Phone (217) 824-4939

Other identifiers 1

IdentifierTypeStateIssuer
14D0435310OtherCLIA

National Provider Directory

National Provider Directory
Tax ID family
Taylorville Medical Associates Lab63 organizations share this tax ID, including this one
Part of
Taylorville Medical Associates Lab

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217548800000",
    "number": "1245498104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E BIDWELL ST",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625681363",
            "telephone_number": "217-824-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E BIDWELL ST",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625681363",
            "telephone_number": "217-824-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAYLORVILLE MEDICAL ASSOCIATES LAB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPRINGFIELD CLINIC LLP",
        "enumeration_date": "2008-05-28",
        "last_updated": "2008-08-01",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "217-528-7541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "14D0435310",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylorville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.