Metrosouth Medical Center

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

041144975 Issued in IL

Legal business name

METROSOUTH MEDICAL CENTER

Doing business as

hospital

Practice address

12935 Gregory St
Blue Island, IL 60406-2428

Phone

(708) 597-2000

NPI assigned

Feb 4, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Kimberly Ward, BSN

Title

Manager 5S

Phone

(708) 597-2000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• hospital Doing business as

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3929/brand/1/csg/22/fhir/r4

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

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265241600000",
    "number": "1316279003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12935 GREGORY ST",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062428",
            "telephone_number": "708-597-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12935 GREGORY ST",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062428",
            "telephone_number": "708-597-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROSOUTH MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-04",
        "last_updated": "2010-02-04",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "MANAGER 5S",
        "authorized_official_telephone_number": "708-597-2000",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BSN"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "041144975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILL. DEPT OF PROFESSIONAL REGULATION REG PROF NURSE",
            "identifier": "041144975",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Acute Care Hospital in Blue Island, IL
• Providers in Blue Island, IL by specialty
• General Acute Care Hospital in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; 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.