NPIMap

Organization Active NPI

HSHS Prairie, Inc

Doing business as HSHS Prairie Foot and Ankle - Jacksonville

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, IL
National Provider Identifier
1629465414
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
HSHS PRAIRIE, INC
Doing business as
HSHS Prairie Foot and Ankle - Jacksonville
Practice address
1745 W Walnut St
Jacksonville, IL 62650-6126
Phone
(005) 326-2798
Fax
(217) 243-5003
NPI assigned
Apr 20, 2015
Last updated
Oct 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Authorized official

Name
Heath M. Roberts
Title
President
Phone
(217) 492-9648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1745 W Walnut St
Jacksonville, IL 62650-6126

Mailing address

3051 Hollis Dr FL 2
Springfield, IL 62704-7450
Phone (217) 492-9695

Other names 1

  • HSHS Prairie Foot and Ankle - Jacksonville Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160901000912 IL DME Supplier - Sports MedicineDME Supplier - Orthotic Personnel 5092857821 Practice locations: Jacksonville, IL

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
HSHS Medical Group Foot and Ankle1745 W Walnut St, Jacksonville, IL 62650-6126(800) 532-6279 Contracture Treatment Devices: Dynamic Splint|Negative Pressure Wound Therapy Pumps/Supplies|Pneumatic Compression Devices and/or Supplies|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf|Surgical Dressings|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Accepts assignmentParticipating since Oct 1, 2009

National Provider Directory

National Provider Directory
Tax ID family
Sewhshs Medical Group Inc18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 71

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 71

NPI Registry JSON

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792022400000",
    "number": "1629465414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 HOLLIS DR FL 2",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047450",
            "telephone_number": "217-492-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626506126",
            "telephone_number": "005-326-2798",
            "fax_number": "217-243-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HSHS PRAIRIE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-20",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "HEATH",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-492-9648"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HSHS Prairie Foot and Ankle - Jacksonville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 15, 2026; 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.