Carle Clinic Association, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CARLE CLINIC ASSOCIATION, PC

Practice address

301 E Southline Rd
Tuscola, IL 61953-2014

Phone

(217) 253-5231

NPI assigned

Mar 29, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kirk Moberg, M.D., PH.D.

Title

Senior Vice President

Phone

(217) 337-4105

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295855088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E SOUTHLINE RD",
            "city": "TUSCOLA",
            "state": "IL",
            "postal_code": "619532014",
            "telephone_number": "217-253-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E SOUTHLINE RD",
            "city": "TUSCOLA",
            "state": "IL",
            "postal_code": "619532014",
            "telephone_number": "217-253-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLE CLINIC ASSOCIATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOBERG",
        "authorized_official_first_name": "KIRK",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "217-337-4105",
        "authorized_official_credential": "M.D., PH.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brookstone Estates of Tuscola, LLC
• Shane Brown, LPC
• David Kameron Browning
• Leah Burris
• Paul H. Byron, H.I.S.
• Carle Clinic Association, PC
• Carle Health Care Incorporated (Carle Physician Group)
• Carle Health Care Incorporated (Carle Physician Group)
• Champion Fitness, Inc (CF Physical Therapy)
• Christie Clinic, PLLC

• Family Medicine Physician in Tuscola, IL
• Providers in Tuscola, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.