Gibson Community Hospital Association
Organization Active NPI Rural Health Clinic/Center · Potomac, IL
NPI 1356779417 · NPPES record last updated Oct 28, 2013
Key facts
- NPI
- 1356779417
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- 0000836 (IL)
- Legal business name
- GIBSON COMMUNITY HOSPITAL ASSOCIATION
- Practice address
- 106 E. State St
Potomac, IL 61865 - Phone
- (217) 987-6300
- Fax
- (217) 987-6333
- NPI assigned
- Oct 28, 2013
- Organization subpart
- No
Authorized official
- Name
- Robert C Schmitt II
- Title
- Ceo
- Phone
- (217) 784-2600
Other NPIs on the same Medicare enrollment 38
Practitioners 3
-
Mohamed I Jabri, MD
-
Carrie Kirby, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040505001293 | IL | Part B Supplier - Clinic/Group Practice | 5092703124 |
Receives reassigned benefits from 201 practitioners 38 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Watseka, IL; Urbana, IL; Paxton, IL; Fairbury, IL; Onarga, IL; Mahomet, IL; Hoopeston, IL; Gibson City, IL… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | 0000836 | IL | Yes |
Addresses
Primary practice location
106 E. State St
Potomac, IL 61865
Mailing address
106 E. State St
Potomac, IL 61865
Phone (217) 987-6300
Other names
- Family Healthcare of Potomac
Other providers in Potomac, IL
- Bluegrass Fire Protection District
- Gateway Family Services of Illinois
- Gateway Family Services of Illinois
- Kristen C Hammel
- Emily Harms
- Jacquelyn Melissa Matias
- Katherine Meid
- Julia L Pettersen
All providers in Potomac, IL · Rural Health Clinic/Center in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.