NPIMap

Organization Active NPI

McDonough County Hospital District

Doing business as MDH Convenient Care

  • Clinic/Center
  • Macomb, IL
National Provider Identifier
1336436765
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
0001438 Issued in IL
Legal business name
MCDONOUGH COUNTY HOSPITAL DISTRICT
Doing business as
MDH Convenient Care
Practice address
1600 E Jackson St
Macomb, IL 61455-2530
Phone
(309) 833-4101
NPI assigned
Jul 6, 2011
Last updated
Jul 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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

Authorized official

Name
Kenneth Boyd Jr.
Title
Ceo
Phone
(309) 833-4101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 0001438 IL Primary

Addresses

Primary practice location

1600 E Jackson St
Macomb, IL 61455-2530

Mailing address

525 E Grant St
Macomb, IL 61455-3313

Other names 1

  • MDH Convenient Care Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309910400000",
    "number": "1336436765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E GRANT ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614553313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E JACKSON ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552530",
            "telephone_number": "309-833-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCDONOUGH COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-07-06",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-833-4101",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "0001438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MDH Convenient Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macomb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; 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.