NPIMap

Organization Active NPI

Carle Health Care Incorporated

Doing business as Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
National Provider Identifier
1336482025
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CARLE HEALTH CARE INCORPORATED
Doing business as
Carle Physician Group
Practice address
602 W University Ave
Urbana, IL 61801-2530
Phone
(217) 383-8300
NPI assigned
Apr 1, 2013
Last updated
Apr 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Authorized official

Name
Mr. John Snyder
Title
Vice Chairman
Phone
(217) 383-4604

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Adult Medicine Physician 207QA0505X
Internal Medicine Physician 207R00000X Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X
Pediatrics Physician 208000000X

Addresses

Primary practice location

602 W University Ave
Urbana, IL 61801-2530

Mailing address

611 W Park St
Urbana, IL 61801-2500
Phone (217) 383-6792

Other identifiers 1

IdentifierTypeStateIssuer
DQ3650OtherILMEDICARE RR

Other names 1

  • Carle Physician Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Arrow Amb SVC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364774400000",
    "number": "1336482025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 W UNIVERSITY AVE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012530",
            "telephone_number": "217-383-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLE HEALTH CARE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-01",
        "last_updated": "2013-04-01",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VICE CHAIRMAN",
        "authorized_official_telephone_number": "217-383-4604",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "DQ3650",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carle Physician Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Urbana, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; 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.