NPIMap

Individual provider Active NPI

Jean Benoit Houle, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Mount Vernon, IL
National Provider Identifier
1639146103
Registry record updated Dec 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
036097382 Issued in IL
Practice address
4121 Veterans Memorial Dr
Mount Vernon, IL 62864-6262
Phone
(618) 242-3778
Fax
(618) 242-2551
NPI assigned
Mar 3, 2006
Last updated
Dec 23, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 036097382 IL Primary

Addresses

Primary practice location

4121 Veterans Memorial Dr
Mount Vernon, IL 62864-6262

Mailing address

4121 Veterans Memorial Dr
Mount Vernon, IL 62864-6262
Phone (618) 242-3778

Other identifiers 1

IdentifierTypeStateIssuer
036097382MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100604000777 IL Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 9638209463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

1104 W Main St
Benton, IL 62812-1565
Phone (618) 439-3399

326 E Main St
West Frankfort, IL 62896-2402
Phone (618) 937-6200

4121 Veterans Memorial Dr
Mount Vernon, IL 62864-6262
Phone (618) 242-3778

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement43
Knee replacement126
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036097382ILMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Center of Southern Illinois, LTD. Sports Medicine Current Accepting new patients
Orthopaedic Center of Southern Illinois, LTD. Sports Medicine CurrentSince Jun 1, 1998 Accepting new patients
St. Mary's Hospital, Centralia, Illinois PastSince Jan 1, 2012 Accepting new patients

Locations

4121 Veterans Memorial Dr
Mount Vernon, IL 62864
Phone (618) 242-8887

705 S Grand St
Nashville, IL 62263
Phone (618) 327-2200

Interoperability endpoints

  • Direct secure messaging: jhoule@yourcarecommunity.org
  • Direct secure messaging: jhoule81986@direct-ehr-ssmhc.com

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
SSM Health Good Samaritan Hospital - Mt. VernonMount Vernon, IL, CCN 140046 Hospital Corporate Director Dec 31, 2022
SSM Health St. Mary's Hospital-CentraliaCentralia, IL, CCN 14S034 Hospital Corporate Director Dec 31, 2022
SSM Health St. Mary's Hospital - CentraliaCentralia, IL, CCN 140034 Hospital Corporate Director Dec 31, 2022
SSM Health Good Samaritan Hospital - Mt VernonMount Vernon, IL, CCN 14T046 Hospital Corporate Director Dec 31, 2022

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261526400000",
    "number": "1639146103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 VETERANS MEMORIAL DR",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646262",
            "telephone_number": "618-242-3778",
            "fax_number": "618-242-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 VETERANS MEMORIAL DR",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646262",
            "telephone_number": "618-242-3778",
            "fax_number": "618-242-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOULE",
        "first_name": "JEAN BENOIT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2009-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IL",
            "license": "036097382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036097382",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

Verify at the official NPI Registry.