Mid-Illinois Medical Care Associates, LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC

Doing business as

Runde Clinic

Practice address

206 N Pearl
Teutopolis, IL 62467

Phone

(217) 857-6481

Fax

(217) 857-6094

NPI assigned

Oct 22, 2007

Last updated

Jun 27, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLCAs reported in NPPES

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

Authorized official

Name

Dr. Eugene P. Dust, M.D.

Title

President of LLC

Phone

(217) 347-5917

Specialties & licenses 1

Addresses

Other names 1

• Runde Clinic Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Part of

Mid-Illinois Medical Ca

Change-of-ownership history 1

Change of ownership 1

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

• Springfield Clinic LLP

  • Rural Health Clinic/Center
  • Teutopolis, IL
  • NPI 1316697600

  Sold to, 2022-07-01

  CMS change of ownership

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498521600000",
    "number": "1477742831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 NETWORK CENTRE DR STE 3",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624014632",
            "telephone_number": "217-347-2707",
            "fax_number": "217-347-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N PEARL",
            "city": "TEUTOPOLIS",
            "state": "IL",
            "postal_code": "62467",
            "telephone_number": "217-857-6481",
            "fax_number": "217-857-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC",
        "enumeration_date": "2007-10-22",
        "last_updated": "2017-06-27",
        "status": "A",
        "authorized_official_last_name": "DUST",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT OF LLC",
        "authorized_official_telephone_number": "217-347-5917",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Runde Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Becky L McGinnis, APN, CNP
• Kari McManaway
• John U. Merkel, M.D.
• Kameran Claire Meyer
• Whitney Meyer
• John Neihls
• Emily Marie Nosbisch, NP
• Charity Ozenkoski
• Repking Eye Care PLLC (Repking Eye Care)
• Brian Repking, O.D.

• Rural Health Clinic/Center in Teutopolis, IL
• Providers in Teutopolis, IL by specialty
• Rural Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.