NPIMap

Organization Active NPI

Proctor Health Systems

Doing business as Associated Family Physicians

  • Primary Care Clinic/Center
  • Bartonville, IL
National Provider Identifier
1437103231
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PROCTOR HEALTH SYSTEMS
Doing business as
Associated Family Physicians
Practice address
1506 W Garfield Ave
Bartonville, IL 61607-1755
Phone
(309) 698-2416
Fax
(309) 697-2749
NPI assigned
May 19, 2006
Last updated
Mar 1, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
PROCTOR HEALTH SYSTEMSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

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

Authorized official

Name
Michele Waldbeesser
Title
Office Manager
Phone
(309) 697-2416

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1506 W Garfield Ave
Bartonville, IL 61607-1755

Mailing address

1506 W Garfield Ave
Bartonville, IL 61607-1755
Phone (309) 697-2416

Other names 1

  • ASSOCIATED FAMILY PHYSICIANS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040227000906 IL Part B Supplier - Clinic/Group Practice 3476440173 Receives reassigned benefits from 378 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Galesburg, IL; Washington, IL; Spring Valley, IL; Princeton, IL; Peoria, IL; Pekin, IL; Morton, IL; Metamora, IL…

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory
Part of
Chillicothe Valley Medi

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267401600000",
    "number": "1437103231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 W GARFIELD AVE",
            "city": "BARTONVILLE",
            "state": "IL",
            "postal_code": "616071755",
            "telephone_number": "309-697-2416",
            "fax_number": "309-697-2749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 W GARFIELD AVE",
            "city": "BARTONVILLE",
            "state": "IL",
            "postal_code": "616071755",
            "telephone_number": "309-698-2416",
            "fax_number": "309-697-2749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCTOR HEALTH SYSTEMS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROCTOR HEALTH SYSTEMS",
        "enumeration_date": "2006-05-19",
        "last_updated": "2010-03-01",
        "status": "A",
        "authorized_official_last_name": "WALDBEESSER",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "309-697-2416"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ASSOCIATED FAMILY PHYSICIANS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bartonville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2010; 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.