Villa House, Inc

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

94S200 Issued in IL

Legal business name

VILLA HOUSE, INC

Doing business as

Villa House, Inc

Practice address

1112 Washington Ave
Johnston City, IL 62951-1536

Phone

(618) 983-8513

Fax

(618) 983-8513

NPI assigned

Apr 10, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robin Dodson

Title

Exec. Director

Phone

(618) 983-8513

Specialties & licenses 1

Addresses

Other names 1

• Villa House, Inc Doing business as

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346363553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 WASHINGTON AVE",
            "address_2": "P O BOX 299",
            "city": "JOHNSTON CITY",
            "state": "IL",
            "postal_code": "629511536",
            "telephone_number": "618-983-8513",
            "fax_number": "618-983-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 WASHINGTON AVE",
            "city": "JOHNSTON CITY",
            "state": "IL",
            "postal_code": "629511536",
            "telephone_number": "618-983-8513",
            "fax_number": "618-983-8513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA HOUSE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DODSON",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "EXEC. DIRECTOR",
        "authorized_official_telephone_number": "618-983-8513"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "IL",
            "license": "94S200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Villa House, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shawnee Health Service and Development Corp (Johnston City High School Health Center)
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• Sabrina Lynn Stevens, FNP-C
• Kenneth J. Sutton, LPN
• Lori A. Thompson, RN
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• Warrior Service Company LLC
• Tammy Sue Yates, LPN

• Exclusive Provider Organization in Johnston City, IL
• Providers in Johnston City, IL by specialty
• Exclusive Provider Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.