NPIMap

Organization Active NPI

Passavant Memorial Area Hospital Association

  • Skilled Nursing Facility
  • Jacksonville, IL
National Provider Identifier
1629115050
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION
Practice address
1600 W Walnut St
Jacksonville, IL 62650
Phone
(217) 245-9541
Fax
(217) 479-8781
NPI assigned
Feb 1, 2007
Last updated
Jul 29, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MEMORIAL HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Authorized official

Name
Mr. Robert L Siltman
Title
Director, Patient Financial Service
Phone
(217) 245-9541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X IL Primary

Addresses

Primary practice location

1600 W Walnut St
Jacksonville, IL 62650

Mailing address

1600 W Walnut St
Jacksonville, IL 62650-1136
Phone (217) 245-9541

Other identifiers 1

IdentifierTypeStateIssuer
50317OtherILBLUE CROSS

Other names 1

  • PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1629115050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501136",
            "telephone_number": "217-245-9541",
            "fax_number": "217-479-8781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "62650",
            "telephone_number": "217-245-9541",
            "fax_number": "217-479-8781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HEALTH SYSTEM",
        "enumeration_date": "2007-02-01",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "SILTMAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR, PATIENT FINANCIAL SERVICE",
        "authorized_official_telephone_number": "217-245-9541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "50317",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksonville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.