Organization Active NPI

Nolen Clinic LTD.

  • Health Service Clinic/Center
  • West Frankfort, IL
National Provider Identifier
1326348152
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
038003613 Issued in IL
Legal business name
NOLEN CLINIC LTD.
Practice address
107 S Van Buren St
West Frankfort, IL 62896-2907
Phone
(618) 937-4164
Fax
(618) 932-3203
NPI assigned
Oct 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Authorized official

Name
Dr. John Alan Nolen, D.C.NPI 1376559062
Title
President
Phone
(618) 937-4164

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 038003613 IL Primary

Addresses

Primary practice location

107 S Van Buren St
West Frankfort, IL 62896-2907

Mailing address

PO Box 8
West Frankfort, IL 62896-0008
Phone (618) 937-4164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101203000647 IL Part B Supplier - Clinic/Group Practice 9133316110 Receives reassigned benefits from 1 practitioner
Practice locations: West Frankfort, IL

National Provider Directory

National Provider Directory

Locations

1000 Factory Outlet Blvd
Ste 111
West Frankfort, IL 62896
Phone (618) 932-4164

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1326348152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628960008",
            "telephone_number": "618-937-4164",
            "fax_number": "618-932-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S VAN BUREN ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962907",
            "telephone_number": "618-937-4164",
            "fax_number": "618-932-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOLEN CLINIC LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-27",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "NOLEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-937-4164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "IL",
            "license": "038003613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Frankfort, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.