City of Carterville

Primary specialty

AmbulanceTaxonomy code 341600000X

License

1769908 Issued in IL

Legal business name

CITY OF CARTERVILLE

Practice address

300 N Division St
Carterville, IL 62918-1272

Phone

(618) 985-6528

Fax

(618) 985-6528

NPI assigned

Mar 15, 2007

Last updated

Mar 21, 2012By 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

Mr. Charles W. Mausey

Title

Mayor

Phone

(618) 985-2700

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332288000000",
    "number": "1376677021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S DIVISION ST",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629181358",
            "telephone_number": "618-985-2252",
            "fax_number": "618-985-9282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N DIVISION ST",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629181272",
            "telephone_number": "618-985-6528",
            "fax_number": "618-985-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF CARTERVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2012-03-21",
        "status": "A",
        "authorized_official_last_name": "MAUSEY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "MAYOR",
        "authorized_official_telephone_number": "618-985-2700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "1769908",
            "primary": true
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "1769909",
            "primary": false
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "1769910",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAI LROAD MEDICARE",
            "identifier": "590002427",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deanna Childers, LCPC
• Lakshmi Manogna Chintalacheruvu, MD
• Christian Social Services of Illinois (Caritas Family Solutions)
• Hunter Church
• Shoshana B Church, PA
• Angela Dawn Clay, MS CCC-SLP
• John Robert Clement, MD
• Darneshia Coleman
• Angela Congiardo, LPN
• Danielle Conner, MSW, LSW

• Ambulance in Carterville, IL
• Providers in Carterville, IL by specialty
• Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.