NPIMap

Organization Active NPI

Saint James Hospital

Doing business as OSF Healthcare - Medical Group (Non-RHC Billing)

  • Family Medicine Physician
  • Clinton, IL
National Provider Identifier
1356058119
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAINT JAMES HOSPITAL
Doing business as
OSF Healthcare - Medical Group (Non-RHC Billing)
Practice address
1231 Kleemann Dr
Clinton, IL 61727-2633
Phone
(217) 935-5022
NPI assigned
Nov 1, 2022
Last updated
Nov 1, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
OSF HEALTHCARE SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Authorized official

Name
Robert Carl Sehring
Title
Chief Executive Officer
Phone
(309) 655-7869

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1231 Kleemann Dr
Clinton, IL 61727-2633

Mailing address

124 SW Adams St
Peoria, IL 61602-1308
Phone (309) 655-2850

Other names 1

  • OSF Healthcare - Medical Group (Non-RHC Billing) Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040804001073 IL Part B Supplier - Clinic/Group Practice 0648187252 Receives reassigned benefits from 144 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dwight, IL; Roanoke, IL; Pontiac, IL; Minonk, IL; Flanagan, IL; Fairbury, IL; El Paso, IL; Cullom, IL…

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Osf Healthcare System

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667260800000",
    "number": "1356058119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 SW ADAMS ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021308",
            "telephone_number": "309-655-2850",
            "fax_number": "309-655-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 KLEEMANN DR",
            "city": "CLINTON",
            "state": "IL",
            "postal_code": "617272633",
            "telephone_number": "217-935-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT JAMES HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OSF HEALTHCARE SYSTEM",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A",
        "authorized_official_last_name": "SEHRING",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "309-655-7869"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OSF Healthcare - Medical Group (Non-RHC Billing)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.