NPIMap

Individual provider Active NPI

Carol Hurley, M.D.

  • Emergency Medicine Physician
  • Alton, IL
National Provider Identifier
1417974957
Registry record updated Mar 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
R4135 Issued in MO
Practice address
1 Memorial Dr
Alton, IL 62002-6722
Phone
(314) 434-0600
NPI assigned
Jul 17, 2006
Last updated
Mar 1, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036-041772 IL
Emergency Medicine Physician 207P00000X 30276 KY
Emergency Medicine Physician 207P00000X R4135 MO Primary

Addresses

Primary practice location

1 Memorial Dr
Alton, IL 62002-6722

Mailing address

75 Remit Drive
Lockbox 1876
Chicago, IL 60675-1876
Phone (866) 916-5259

Other identifiers 3

IdentifierTypeStateIssuer
1417974957MedicaidMO
036041772MedicaidIL
208240515MedicaidMO

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-041772ILMDEmergency Medicine Physician
30276KYMDEmergency Medicine Physician
R4135MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BC Missouri Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
Inphynet Contracting Services LLC Emergency Medicine Past Accepting new patients
BC Illinois Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
BC Missouri Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
Saint Anthony's Physician Group Past Accepting new patients
BC Missouri Emergency Physicians LLP Emergency Medicine Past Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1417974957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMIT DRIVE",
            "address_2": "LOCKBOX 1876",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606751876",
            "telephone_number": "866-916-5259",
            "fax_number": "231-922-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEMORIAL DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026722",
            "telephone_number": "314-434-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURLEY",
        "first_name": "CAROL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-041772",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "30276",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "R4135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417974957",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036041772",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208240515",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.