NPIMap

Organization Active NPI

Harrisburg Family Practice LTD

Doing business as Primary Care Group

  • Family Medicine Physician
  • Harrisburg, IL
National Provider Identifier
1265419261
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036042756 Issued in IL
Legal business name
HARRISBURG FAMILY PRACTICE LTD
Doing business as
Primary Care Group
Practice address
117 E Clark St
Harrisburg, IL 62946-2702
Phone
(618) 252-8625
Fax
(618) 252-2540
NPI assigned
Dec 30, 2005
Last updated
Sep 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Authorized official

Name
Michelle Boatright
Title
Administrator
Phone
(618) 252-8625

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 036042756 IL Primary

Addresses

Primary practice location

117 E Clark St
Harrisburg, IL 62946-2702

Mailing address

117 E Clark St
Harrisburg, IL 62946-2702
Phone (618) 252-8625

Other names 1

  • Primary Care Group Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316649600000",
    "number": "1265419261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E CLARK ST",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629462702",
            "telephone_number": "618-252-8625",
            "fax_number": "618-252-2540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E CLARK ST",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629462702",
            "telephone_number": "618-252-8625",
            "fax_number": "618-252-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRISBURG FAMILY PRACTICE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-30",
        "last_updated": "2011-09-22",
        "status": "A",
        "authorized_official_last_name": "BOATRIGHT",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "618-252-8625"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036042756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrisburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.