NPIMap

Organization Active NPI

Lewis Memorial Christian Village

  • Preferred Provider Organization
  • Springfield, IL
National Provider Identifier
1417264391
Registry record updated Sep 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
160003483 Issued in IL
Legal business name
LEWIS MEMORIAL CHRISTIAN VILLAGE
Practice address
3400 W Washington St
Springfield, IL 62711-7917
Phone
(217) 787-9600
NPI assigned
Sep 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2010

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

Authorized official

Name
Susan Hensey
Title
Pta
Phone
(217) 787-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 160003483 IL Primary

Addresses

Primary practice location

3400 W Washington St
Springfield, IL 62711-7917

Mailing address

3400 W Washington St
Springfield, IL 62711-7917
Phone (217) 787-9600

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284336000000",
    "number": "1417264391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 W WASHINGTON ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627117917",
            "telephone_number": "217-787-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W WASHINGTON ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627117917",
            "telephone_number": "217-787-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS MEMORIAL CHRISTIAN VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-13",
        "last_updated": "2010-09-13",
        "status": "A",
        "authorized_official_last_name": "HENSEY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PTA",
        "authorized_official_telephone_number": "217-787-9600"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "IL",
            "license": "160003483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 13, 2010; 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.