Organization Active NPI

Physicians Care Network, Inc.

  • Health Maintenance Organization
  • Rockford, IL
National Provider Identifier
1467534032
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
PHYSICIANS CARE NETWORK, INC.
Practice address
630 E Jefferson St
Rockford, IL 61107-4026
Phone
(815) 490-6781
NPI assigned
Oct 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Cameron Brown
Title
President Ceo
Phone
(815) 490-6781

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X NU Primary

Addresses

Primary practice location

630 E Jefferson St
Rockford, IL 61107-4026

Mailing address

630 E Jefferson St
Rockford, IL 61107-4026

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467534032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 E JEFFERSON ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611074026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E JEFFERSON ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611074026",
            "telephone_number": "815-490-6781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS CARE NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "815-490-6781",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.