NPIMap

Organization Active NPI

National Healthcare of Mt Vernon Inc

Doing business as Crossroads Internal Medicine RHC

  • Rural Health Clinic/Center
  • Mount Vernon, IL
National Provider Identifier
1447814405
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
NATIONAL HEALTHCARE OF MT VERNON INC
Doing business as
Crossroads Internal Medicine RHC
Practice address
4101 N Water Tower PL
Mount Vernon, IL 62864-6296
Phone
(618) 244-4313
NPI assigned
Apr 25, 2019
Last updated
Jul 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Authorized official

Name
Laura J Fey
Title
Sr. Director Physician Rev Cycle
Phone
(615) 221-3641

Specialties & licenses 1

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

Addresses

Primary practice location

4101 N Water Tower PL
Mount Vernon, IL 62864-6296

Mailing address

PO Box 11802
Belfast, ME 04915-4009

Other names 1

  • Crossroads Internal Medicine RHC Doing business as

Medicare participation

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

National Provider Directory

National Provider Directory

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jan 14, 2023 Change of OwnershipThis provider was the seller Deaconess Illinois Crossroads Family Clinic - Mt. VernonCCN 148605, IL, NPI 1316663602

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 8

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": "1556150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1447814405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11802",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 N WATER TOWER PL",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646296",
            "telephone_number": "618-244-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL HEALTHCARE OF MT VERNON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-25",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A",
        "authorized_official_last_name": "FEY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SR. DIRECTOR PHYSICIAN REV CYCLE",
        "authorized_official_telephone_number": "615-221-3641"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Internal Medicine RHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Vernon, IL

Sources for this page

Verify at the official NPI Registry.