NPIMap

Organization Active NPI

Sinnissippi Centers, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mount Carroll, IL
National Provider Identifier
1366739781
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SINNISSIPPI CENTERS, INC.
Practice address
1122 Healthcare Dr
Mount Carroll, IL 61053-1461
Phone
(815) 244-1376
Fax
(815) 244-3074
NPI assigned
Jul 6, 2011
Last updated
Jul 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Authorized official

Name
Teresa A Good, CPA
Title
VP/Cfo
Phone
(815) 284-6611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

1122 Healthcare Dr
Mount Carroll, IL 61053-1461

Mailing address

325 Il Route 2
Dixon, IL 61021-9118
Phone (815) 284-6611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031208000895 IL Part B Supplier - Clinic/Group Practice 3476459876 Receives reassigned benefits from 61 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rochelle, IL; Sterling, IL; Oregon, IL; Mount Carroll, IL; Dixon, IL

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Sinnissippi Centers Inc25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 47

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 47

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1366739781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 IL ROUTE 2",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610219118",
            "telephone_number": "815-284-6611",
            "fax_number": "815-284-2834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 HEALTHCARE DR",
            "city": "MOUNT CARROLL",
            "state": "IL",
            "postal_code": "610531461",
            "telephone_number": "815-244-1376",
            "fax_number": "815-244-3074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SINNISSIPPI CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-06",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A",
        "authorized_official_last_name": "GOOD",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "815-284-6611",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Carroll, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.