Individual provider Active NPI

Craig S Vinch, MD

  • Cardiovascular Disease Physician
  • Belleville, IL
National Provider Identifier
1275515561
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036136030 Issued in IL
Practice address
340 W Lincoln St
Ste. 400
Belleville, IL 62220-1900
Phone
(618) 233-6044
Fax
(618) 233-5195
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 160974 MA
Cardiovascular Disease Physician 207RC0000X 036136030 IL Primary

Addresses

Primary practice location

340 W Lincoln St
Ste. 400
Belleville, IL 62220-1900

Mailing address

340 W Lincoln St
Ste. 400
Belleville, IL 62220-1900
Phone (618) 233-6044

Other identifiers 3

IdentifierTypeStateIssuer
036136030MedicaidIL
P01374239OtherILRAILROAD
3198626MedicaidMA

Other names 1

  • Craig S Vinch Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036136030ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laurence J. Sloss, M.D. Cardiovascular Disease PastSince May 19, 2010 Accepting new patients
Cardiology Consultants LTD Cardiovascular Disease Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492387200000",
    "number": "1275515561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 W LINCOLN ST",
            "address_2": "STE. 400",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201900",
            "telephone_number": "618-233-6044",
            "fax_number": "618-233-5195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 W LINCOLN ST",
            "address_2": "STE. 400",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201900",
            "telephone_number": "618-233-6044",
            "fax_number": "618-233-5195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCH",
        "first_name": "CRAIG",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2017-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MA",
            "license": "160974",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036136030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036136030",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P01374239",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3198626",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRAIG",
            "last_name": "VINCH",
            "middle_name": "S",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; 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.