Active NPI
Pekin Memorial Hospital
Doing business as Pekin Hospital
- Certified Registered Nurse Anesthetist
- Pekin, IL
National Provider Identifier
1306978457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 0001834
- Legal business name
- PEKIN MEMORIAL HOSPITAL
- Doing business as
- Pekin Hospital
- Practice address
- 600 S 13TH St
Pekin, IL 61554-4936 - Phone
- (309) 353-0406
- Fax
- (309) 347-1240
- NPI assigned
- Mar 12, 2007
- Last updated
- Jul 6, 2012
- Organization subpart
- Yes
- Parent organization
- PEKIN MEMORIAL HOSPTIAL
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gary Jepson
- Title
- Ceo
- Phone
- (309) 353-0756
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 0001834 | IL | Primary |
Addresses
Primary practice location
600 S 13TH St
Pekin, IL 61554-4936
Mailing address
600 S 13TH St
Pekin, IL 61554-4936
Phone (309) 353-0406
Other names 1
- Pekin Hospital
National Provider Directory
National Provider Directory- Part of
- Pekin Hospital-Crna
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1341532800000",
"number": "1306978457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 S 13TH ST",
"city": "PEKIN",
"state": "IL",
"postal_code": "615544936",
"telephone_number": "309-353-0406",
"fax_number": "309-347-1240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 S 13TH ST",
"city": "PEKIN",
"state": "IL",
"postal_code": "615544936",
"telephone_number": "309-353-0406",
"fax_number": "309-347-1240"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEKIN MEMORIAL HOSPITAL",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PEKIN MEMORIAL HOSPTIAL",
"enumeration_date": "2007-03-12",
"last_updated": "2012-07-06",
"status": "A",
"authorized_official_last_name": "JEPSON",
"authorized_official_first_name": "GARY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "309-353-0756"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IL",
"license": "0001834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Pekin Hospital",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Pekin, IL
- Pekin Memorial Hospital (Pekin Hospital HHC)
- Pekin Memorial Hospital (Pekin Hospital)
- Pekin Memorial Hospital (Pekin Hospital SNF)
- Pekin Memorial Hospital (Pekin Hospital)
- Pekin Memorial Hospital (Pekin Hospital)
- Pekin MRI, LLC
- Pekin Podiatric Medical Center, P.C
- Pekin Prescription Laboratory, Inc.
- Pekin Prohealth Inc
- Pekin Prohealth Inc (PHI X-Ray)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.