Southern Seven Health Dept

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

SOUTHERN SEVEN HEALTH DEPT

Practice address

37 Rustic Campus Dr
Ullin, IL 62992-2226

Phone

(618) 634-2297

Fax

(618) 634-9011

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Rhonda Andrews-Ray

Title

Executive Director

Phone

(618) 634-2297

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carolyn D. Kissiar, CNP

  • Gynecology Physician
  • Ullin, IL
  • NPI 1861716532
  NPD (past)
• Mary Livesay

  • Family Nurse Practitioner
  • Ullin, IL
  • NPI 1386442093
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1255499463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 RUSTIC CAMPUS DR",
            "city": "ULLIN",
            "state": "IL",
            "postal_code": "629922226",
            "telephone_number": "618-634-2297",
            "fax_number": "618-634-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 RUSTIC CAMPUS DR",
            "city": "ULLIN",
            "state": "IL",
            "postal_code": "629922226",
            "telephone_number": "618-634-2297",
            "fax_number": "618-634-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SEVEN HEALTH DEPT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "ANDREWS-RAY",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-634-2297"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-MASSAC",
            "identifier": "600001850",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-POPE CO",
            "identifier": "600001853",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-ALEX CO",
            "identifier": "600001837",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-HARDIN",
            "identifier": "600001852",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-PULASKI",
            "identifier": "010017185",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE - UNION COUNTY",
            "identifier": "600001836",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-JOHNSON",
            "identifier": "600001851",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lesa Kelly Klosterhoff, PT
• Mary Livesay
• Caitlin M. Marks, SLP
• Sara Paige Nighswander, MS SCHOOL PSYCHOLOGY
• River to River Community of Ullin
• Leslie Elaine Thurston, M.S., CCC-SLP
• Shirley M. Woodard, DEVELOPMENTAL THERAP

• Health Service Clinic/Center in Ullin, IL
• Providers in Ullin, IL by specialty
• Health Service Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.