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Organization Active NPI

Shawnee Health Service and Development Corp

Doing business as Shawnee Health Service and Development Corp IHH

  • Case Management Agency
  • Carterville, IL
National Provider Identifier
1639651706
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Doing business as
Shawnee Health Service and Development Corp IHH
Practice address
109 California St
Carterville, IL 62918-1923
Phone
(618) 519-9200
NPI assigned
Sep 5, 2018
Last updated
Sep 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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

Authorized official

Name
Patsy R Jensen
Title
Ceo
Phone
(618) 985-8221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

109 California St
Carterville, IL 62918-1923

Mailing address

109 California St
PO Box 577
Carterville, IL 62918-0577
Phone (618) 519-9200

Other practice location 1

1006 S Division St
Carterville, IL 62918-1539
Phone (618) 519-9200

Other practice location 2

404 S Lewis Ln
Carbondale, IL 62901-3547
Phone (618) 519-9200

Other practice location 3

101 S Wall St
Carbondale, IL 62901-3021
Phone (618) 519-9200

Other practice location 4

7 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 519-9200

Other practice location 5

1301 E Walnut St
Carbondale, IL 62901-5004
Phone (618) 519-9200

Other practice location 6

1700 Wildcat Dr
Marion, IL 62959-1507
Phone (618) 519-9200

Other practice location 7

400 S Lewis Ln
Carbondale, IL 62901-3547
Phone (618) 519-9200

Other practice location 8

1506 Sioux Dr
Marion, IL 62959-5209
Phone (618) 519-9200

Other names 1

  • Shawnee Health Service and Development Corp IHH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Shawnee Health Service37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

View all 36

Locations

1150 E Grand Ave
Rm 183A
Carbondale, IL 62901

400 S Lewis Ln
Carbondale, IL 62901
Phone (618) 519-9900

1006 S Division St
Carterville, IL 62918
Phone (618) 985-4841

109 W Commercial Dr
Carterville, IL 62918

1700 Wildcat Dr
Marion, IL 62959
Phone (618) 969-8228

400 Morningside Dr
Rm A12
Marion, IL 62959

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538006400000",
    "number": "1639651706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CALIFORNIA ST",
            "address_2": "PO BOX 577",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629180577",
            "telephone_number": "618-519-9200",
            "fax_number": "618-985-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CALIFORNIA ST",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629181923",
            "telephone_number": "618-519-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1006 S Division St",
            "address_purpose": "LOCATION",
            "city": "Carterville",
            "state": "IL",
            "postal_code": "629181539",
            "country_code": "US",
            "telephone_number": "618-519-9200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "404 S Lewis Ln",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629013547",
            "country_code": "US",
            "telephone_number": "618-519-9200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 S Wall St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629013021",
            "country_code": "US",
            "telephone_number": "618-519-9200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7 S Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Murphysboro",
            "state": "IL",
            "postal_code": "629663333",
            "country_code": "US",
            "telephone_number": "618-519-9200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1301 E Walnut St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629015004",
            "country_code": "US",
            "telephone_number": "618-519-9200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 Wildcat Dr",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IL",
            "postal_code": "629591507",
            "country_code": "US",
            "telephone_number": "618-519-9200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 S Lewis Ln",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629013547",
            "country_code": "US",
            "telephone_number": "618-519-9200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1506 Sioux Dr",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IL",
            "postal_code": "629595209",
            "country_code": "US",
            "telephone_number": "618-519-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-05",
        "last_updated": "2018-09-27",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "PATSY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "618-985-8221"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shawnee Health Service and Development Corp IHH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shawnee Health Service and Development Corp IHH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carterville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; 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.