NPIMap

Organization Active NPI

Jacques Papazian M.D,S.C.

  • Otolaryngology Physician
  • Mount Vernon, IL
National Provider Identifier
1285650838
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
036093598 Issued in IL
Legal business name
JACQUES PAPAZIAN M.D,S.C.
Practice address
4117 S Water Tower PL
Suite C
Mount Vernon, IL 62864-6293
Phone
(618) 242-0672
Fax
(618) 242-0862
NPI assigned
Jul 15, 2006
Last updated
Mar 18, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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

Authorized official

Name
Jacques Papazian, M.D.NPI 1366491193
Title
M.D.
Phone
(618) 242-0672

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 036093598 IL Primary

Addresses

Primary practice location

4117 S Water Tower PL
Suite C
Mount Vernon, IL 62864-6293

Mailing address

4117 S Water Tower PL
Suite C
Mount Vernon, IL 62864-6567
Phone (618) 242-0672

Other identifiers 6

IdentifierTypeStateIssuer
040009944OtherILRAILROAD MEDICARE ID#
04127654OtherILBCBS OF IL PROVIDER#
293973OtherILHEALTHLINK PROVIDER ID#
036093598MedicaidIL
55563OtherILGHP PROVIDER ID#
027794OtherILHEALTH ALLIANCE ID#

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395100800000",
    "number": "1285650838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4117 S WATER TOWER PL",
            "address_2": "SUITE C",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646567",
            "telephone_number": "618-242-0672",
            "fax_number": "618-242-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4117 S WATER TOWER PL",
            "address_2": "SUITE C",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646293",
            "telephone_number": "618-242-0672",
            "fax_number": "618-242-0862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUES PAPAZIAN M.D,S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2014-03-18",
        "status": "A",
        "authorized_official_last_name": "PAPAZIAN",
        "authorized_official_first_name": "JACQUES",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "618-242-0672",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036093598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID#",
            "identifier": "040009944",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL PROVIDER#",
            "identifier": "04127654",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PROVIDER ID#",
            "identifier": "293973",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093598",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP PROVIDER ID#",
            "identifier": "55563",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE ID#",
            "identifier": "027794",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; 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.