NPIMap

Organization Active NPI

Carbondale Rural Health Clinic

  • Rural Health Clinic/Center
  • Carbondale, IL
National Provider Identifier
1417013095
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CARBONDALE RURAL HEALTH CLINIC
Practice address
2601 W Main St
Carbondale, IL 62901-1031
Phone
(618) 549-5361
Fax
(618) 549-5128
NPI assigned
Dec 28, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
CARBONDALE CLINIC, S. CAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mr. Allan N Norman
Title
Chief Executive Officer
Phone
(618) 549-5361

Specialties & licenses 1

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

Addresses

Primary practice location

2601 W Main St
Carbondale, IL 62901-1031

Mailing address

2601 W Main St
Carbondale, IL 62901-1031
Phone (618) 549-5361

National Provider Directory

National Provider Directory
Tax ID family
The Carbondale Clinic Radiology5 organizations share this tax ID, including this one
Part of
The Carbondale Clinic Radiology

Other organizations with this tax ID 4

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": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1417013095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 W MAIN ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011031",
            "telephone_number": "618-549-5361",
            "fax_number": "618-549-5128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 W MAIN ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011031",
            "telephone_number": "618-549-5361",
            "fax_number": "618-549-5128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARBONDALE RURAL HEALTH CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARBONDALE CLINIC, S. C",
        "enumeration_date": "2006-12-28",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "NORMAN",
        "authorized_official_first_name": "ALLAN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "618-549-5361",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.