NPIMap

Organization Active NPI

Cogent Healthcare of Illinois, LLC

  • Internal Medicine Physician
  • Quincy, IL
National Provider Identifier
1487897849
Registry record updated Apr 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COGENT HEALTHCARE OF ILLINOIS, LLC
Practice address
1005 Broadway St
Quincy, IL 62301-2834
Phone
(615) 377-5652
Fax
(888) 241-1404
NPI assigned
Apr 15, 2009
Last updated
Apr 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2009

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

Authorized official

Name
Mr. Ron Greeno, MD
Title
Sole Member
Phone
(949) 399-6003

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364S00000X

Addresses

Primary practice location

1005 Broadway St
Quincy, IL 62301-2834

Mailing address

5410 Maryland Way
Suite 300
Brentwood, TN 37027-5064
Phone (615) 377-5652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100920001157 IL Part B Supplier - Clinic/Group Practice 6507981008 Receives reassigned benefits from 81 practitioners
Practice locations: Belvidere, IL; Marion, IL; Mount Vernon, IL; Rockford, IL

National Provider Directory

National Provider Directory

Locations

1600 W Walnut St
South Jacksonville, IL 62650
Phone (217) 245-7275

Practitioners & affiliated clinicians

Practitioners 121

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.

View all 121

NPI Registry JSON

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239926400000",
    "number": "1487897849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 MARYLAND WAY",
            "address_2": "SUITE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275064",
            "telephone_number": "615-377-5652",
            "fax_number": "888-241-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "615-377-5652",
            "fax_number": "888-241-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COGENT HEALTHCARE OF ILLINOIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-15",
        "last_updated": "2009-04-17",
        "status": "A",
        "authorized_official_last_name": "GREENO",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "949-399-6003",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.