Menard Medical Center, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MENARD MEDICAL CENTER, LLC

Practice address

1 Centre Dr
Petersburg, IL 62675-9467

Phone

(217) 632-7761

Fax

(217) 632-0312

NPI assigned

Oct 2, 2008

Organization subpart

No

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

Authorized official

Name

J. Travis Dowell

Title

Vice President, Hcna and Operations

Phone

(217) 788-3342

Specialties & licenses 2

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Memorial Physician Services

  • Rural Health Clinic/Center
  • Jacksonville, IL
  • NPI 1558614867

  Member Of

  NPD member

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222905600000",
    "number": "1437300043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3428",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627083428",
            "telephone_number": "800-577-5368",
            "fax_number": "217-757-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CENTRE DR",
            "city": "PETERSBURG",
            "state": "IL",
            "postal_code": "626759467",
            "telephone_number": "217-632-7761",
            "fax_number": "217-632-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENARD MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-02",
        "last_updated": "2008-10-02",
        "status": "A",
        "authorized_official_last_name": "DOWELL",
        "authorized_official_first_name": "J. TRAVIS",
        "authorized_official_title_or_position": "VICE PRESIDENT, HCNA AND OPERATIONS",
        "authorized_official_telephone_number": "217-788-3342"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda L. Meeks, M.D.
• Memorial Physician Services
• Menard Convalescent Center, Inc
• Menard Convalescent Center, Inc
• Menard County Health Department
• Menard Medical Center, LLC
• Tracy Ann Muller, MS SLP CCC
• Clara Munyer, SLP-CCC
• David D Newton, M.D.
• Dana Yvette Ogle, PTA

• All providers in Petersburg, IL
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.