NPIMap

Organization Active NPI

Greenville Family Medicine, LLC

  • Rural Health Clinic/Center
  • Greenville, IL
National Provider Identifier
1396336970
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GREENVILLE FAMILY MEDICINE, LLC
Practice address
1000 Red Ball TRL
Greenville, IL 62246-2781
Phone
(618) 664-1240
NPI assigned
Jan 27, 2021
Last updated
Jan 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Authorized official

Name
Kelsey Hopkins, MDNPI 1508012527
Title
Co-Owner
Phone
(618) 664-1240

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1000 Red Ball TRL
Greenville, IL 62246-2781

Mailing address

1000 Red Ball TRL
Greenville, IL 62246-2781
Phone (618) 664-1240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Locations

1000 Red Ball Trl
Greenville, IL 62246
Phone (618) 391-6495

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jan 1, 2026 Change of OwnershipThis provider was the seller SBL Greenville Family MedicineCCN 148679, IL, NPI 1811858970

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1396336970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 RED BALL TRL",
            "city": "GREENVILLE",
            "state": "IL",
            "postal_code": "622462781",
            "telephone_number": "618-664-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 RED BALL TRL",
            "city": "GREENVILLE",
            "state": "IL",
            "postal_code": "622462781",
            "telephone_number": "618-664-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A",
        "authorized_official_last_name": "HOPKINS",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "618-664-1240",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, IL

Sources for this page

Verify at the official NPI Registry.