Organization Active NPI

River City Family Practice SC

  • Family Medicine Physician
  • East Dubuque, IL
National Provider Identifier
1366540205
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RIVER CITY FAMILY PRACTICE SC
Practice address
141 Sinsinawa Ave
East Dubuque, IL 61025-1218
Phone
(815) 747-3114
Fax
(814) 747-3131
NPI assigned
Sep 21, 2006
Last updated
Apr 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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

Authorized official

Name
Michelle M Sprengelmeyer, MD
Title
MD
Phone
(815) 747-3114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

141 Sinsinawa Ave
East Dubuque, IL 61025-1218

Mailing address

141 Sinsinawa Ave
East Dubuque, IL 61025-1218
Phone (815) 747-3114

Other identifiers 1

IdentifierTypeStateIssuer
2137711MedicaidIA

National Provider Directory

National Provider Directory

Locations

141 Sinsinawa Ave
East Dubuque, IL 61025
Phone (815) 747-3114

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1366540205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 SINSINAWA AVE",
            "city": "EAST DUBUQUE",
            "state": "IL",
            "postal_code": "610251218",
            "telephone_number": "815-747-3114",
            "fax_number": "814-747-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 SINSINAWA AVE",
            "city": "EAST DUBUQUE",
            "state": "IL",
            "postal_code": "610251218",
            "telephone_number": "815-747-3114",
            "fax_number": "814-747-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER CITY FAMILY PRACTICE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "SPRENGELMEYER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "815-747-3114",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2137711",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Dubuque, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; 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.