Mount Vernon Medical Enterprises Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MOUNT VERNON MEDICAL ENTERPRISES INC

Practice address

4230 Lincolnshire Dr Ste G
Mount Vernon, IL 62864-2189

Phone

(618) 244-6770

Fax

(618) 244-6772

NPI assigned

Sep 29, 2020

Organization subpart

No

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

Authorized official

Name

Suzanne Alt, DONPI 1811995566

Title

President

Phone

(660) 341-3877

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Suzanne E Alt, DO

  • Family Medicine Physician
  • Mount Vernon, IL
  • NPI 1811995566
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601337600000",
    "number": "1548877947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 LINCOLNSHIRE DR STE G",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642189",
            "telephone_number": "618-244-6770",
            "fax_number": "618-244-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 LINCOLNSHIRE DR STE G",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642189",
            "telephone_number": "618-244-6770",
            "fax_number": "618-244-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT VERNON MEDICAL ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A",
        "authorized_official_last_name": "ALT",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "660-341-3877",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Mooney, LCPC
• Judith C Morgan, RN/BA/CADC
• Mount Vernon Chiropractic Clinic
• Mount Vernon Emergency Group PC
• Mount Vernon Heart Institute LTD
• Kelli Mowrer, CNP
• Mt Vernon Community Pharmacy Inc
• Mt Vernon Community Pharmacy Inc
• Mt Vernon Cty SCH Dist 80
• Mt Vernon Family Practice PC

• Family Medicine Physician in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.