Wabash Memorial Hospital Association

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

36117078 Issued in IL

Legal business name

WABASH MEMORIAL HOSPITAL ASSOCIATION

Practice address

1501 N Water St
Decatur, IL 62526-4441

Phone

(217) 425-9642

Fax

(217) 542-0134

NPI assigned

Jan 17, 2007

Last updated

May 1, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Venita Edwards-Talley, M.D.NPI 1932207131

Title

Clinic Physician

Phone

(217) 425-9642

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Venita R Edwards-Talley, MD

  • Internal Medicine Physician
  • Gainesville, FL
  • NPI 1932207131
  NPD (past) Authorized official

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1497807689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 N WATER ST",
            "address_2": "PO BOX 1340",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264441",
            "telephone_number": "217-425-9642",
            "fax_number": "217-542-0134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N WATER ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264441",
            "telephone_number": "217-425-9642",
            "fax_number": "217-542-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WABASH MEMORIAL HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "EDWARDS-TALLEY",
        "authorized_official_first_name": "VENITA",
        "authorized_official_title_or_position": "CLINIC PHYSICIAN",
        "authorized_official_telephone_number": "217-425-9642",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "36117078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Vieth
• Carole Vilchis, NP
• Villa Clara Post Acute, LLC
• Rebecca A Voyles, MSN, APN, NP-C
• VSR PLLC
• Rebecca Waddell
• James L Wade III, M.D.
• Kristen Lyn Wade, P.T.
• Kyla Aaliyah Ali Wade
• Carolyn Wagner, NP

• Clinic/Center in Decatur, IL
• Providers in Decatur, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.