NPIMap

Organization Active NPI

Midwest Emergency Management, Inc.

  • Urgent Care Clinic/Center
  • O Fallon, IL
National Provider Identifier
1487601506
Registry record updated Mar 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MIDWEST EMERGENCY MANAGEMENT, INC.
Practice address
1512 N Green Mount Rd
O Fallon, IL 62269-1953
Phone
(618) 624-3750
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2018

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

Authorized official

Name
Mr. Carmon L. Glover III, DO
Title
President/Cmo
Phone
(888) 577-6337

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1512 N Green Mount Rd
O Fallon, IL 62269-1953

Mailing address

PO Box 797069
St. Louis, MO 63179-7000
Phone (888) 577-6337

Other identifiers 2

IdentifierTypeStateIssuer
08232205OtherILBLUE CROSS BLUE SHIELD
DF2610OtherILRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 50

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521072000000",
    "number": "1487601506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 797069",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631797000",
            "telephone_number": "888-577-6337",
            "fax_number": "618-624-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 N GREEN MOUNT RD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691953",
            "telephone_number": "618-624-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST EMERGENCY MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2018-03-15",
        "status": "A",
        "authorized_official_last_name": "GLOVER",
        "authorized_official_first_name": "CARMON",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT/CMO",
        "authorized_official_telephone_number": "888-577-6337",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "08232205",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF2610",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; 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.