NPIMap

Organization Active NPI

Springfield Hospital, Inc.

  • Clinical Social Worker
  • Springfield, IL
National Provider Identifier
1407126352
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149012639 Issued in IL
Legal business name
SPRINGFIELD HOSPITAL, INC.
Practice address
5230 S 6TH Street Rd
Springfield, IL 62703-5128
Phone
(217) 585-1180
Fax
(217) 585-4747
NPI assigned
Jan 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Authorized official

Name
Chrstine Statz
Title
Cfo
Phone
(217) 585-1180

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 149012639 IL Primary

Addresses

Primary practice location

5230 S 6TH Street Rd
Springfield, IL 62703-5128

Mailing address

5230 S 6TH Street Rd
Springfield, IL 62703-5128
Phone (217) 585-1180

Other identifiers 1

IdentifierTypeStateIssuer
149012639OtherILLICENSED CLINICAL SOCIAL WORKER MASTERS

Other names 1

  • Lincoln Prairie Behavioral Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lincoln Prairie Behavioral Health Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1407126352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5230 S 6TH STREET RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035128",
            "telephone_number": "217-585-1180",
            "fax_number": "217-585-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 S 6TH STREET RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035128",
            "telephone_number": "217-585-1180",
            "fax_number": "217-585-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGFIELD HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "STATZ",
        "authorized_official_first_name": "CHRSTINE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "217-585-1180"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149012639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED CLINICAL SOCIAL WORKER MASTERS",
            "identifier": "149012639",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lincoln Prairie Behavioral Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.