NPIMap

Organization Active NPI

Healthcare Network Associates of Sangamon

Doing business as Memorial Express Care at Koke Mill

  • Multi-Specialty Clinic/Center
  • Springfield, IL
National Provider Identifier
1588675482
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
HEALTHCARE NETWORK ASSOCIATES OF SANGAMON
Doing business as
Memorial Express Care at Koke Mill
Practice address
3132 Old Jacksonville Rd
Suite 110
Springfield, IL 62704-7400
Phone
(217) 862-0062
Fax
(217) 862-0064
NPI assigned
Aug 10, 2006
Last updated
Jun 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
William T Kendrick Jr.
Title
Director
Phone
(217) 757-7493

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Emergency Medicine Physician 207P00000X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

3132 Old Jacksonville Rd
Suite 110
Springfield, IL 62704-7400

Mailing address

PO Box 3428
Springfield, IL 62708-3428
Phone (217) 757-7491

Other names 1

  • Memorial Express Care at Koke Mill Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Healthcare Network Associates of Sangamon12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1588675482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3428",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627083428",
            "telephone_number": "217-757-7491",
            "fax_number": "217-757-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3132 OLD JACKSONVILLE RD",
            "address_2": "SUITE 110",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047400",
            "telephone_number": "217-862-0062",
            "fax_number": "217-862-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHCARE NETWORK ASSOCIATES OF SANGAMON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "KENDRICK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "217-757-7493",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Express Care at Koke Mill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.