NPIMap

Organization Active NPI

Gibson Community Hospital Association

Doing business as The Paxton Clinic

  • Family Medicine Physician
  • Paxton, IL
National Provider Identifier
1396945960
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GIBSON COMMUNITY HOSPITAL ASSOCIATION
Doing business as
The Paxton Clinic
Practice address
227 N Market St
Paxton, IL 60957-1123
Phone
(217) 379-4864
Fax
(217) 379-2604
NPI assigned
Jul 23, 2007
Last updated
Aug 28, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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

Authorized official

Name
Robert Schmitt
Title
Ceo
Phone
(217) 784-4251

Specialties & licenses 1

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

Addresses

Primary practice location

227 N Market St
Paxton, IL 60957-1123

Mailing address

227 N Market St
Paxton, IL 60957-1123
Phone (217) 379-4864

Other identifiers 1

IdentifierTypeStateIssuer
210191OtherILMEDICARE GROUP

Other names 1

  • THE PAXTON CLINIC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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…

Other NPIs on the same Medicare enrollment 38

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

View all 38

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188259200000",
    "number": "1396945960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 N MARKET ST",
            "city": "PAXTON",
            "state": "IL",
            "postal_code": "609571123",
            "telephone_number": "217-379-4864",
            "fax_number": "217-379-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 N MARKET ST",
            "city": "PAXTON",
            "state": "IL",
            "postal_code": "609571123",
            "telephone_number": "217-379-4864",
            "fax_number": "217-379-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBSON COMMUNITY HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-08-28",
        "status": "A",
        "authorized_official_last_name": "SCHMITT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-784-4251"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "210191",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE PAXTON CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paxton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; 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.