Organization Active NPI

Carle Clinic Association, PC

  • Durable Medical Equipment & Medical Supplies
  • Urbana, IL
National Provider Identifier
1649466186
Registry record updated Sep 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
CARLE CLINIC ASSOCIATION, PC
Practice address
610 N Lincoln Ave
Urbana, IL 61801-2432
Phone
(217) 383-6555
NPI assigned
Sep 19, 2007
Last updated
Sep 19, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2007

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

Authorized official

Name
Kirk Moberg, M.D, PH.D.
Title
Senior Vice President
Phone
(217) 337-4105

Specialties & licenses 1

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

Addresses

Primary practice location

610 N Lincoln Ave
Urbana, IL 61801-2432

Mailing address

610 N Lincoln Ave
Urbana, IL 61801-2432
Phone (217) 383-6555

National Provider Directory

National Provider Directory

Locations

610 N Lincoln Ave
Urbana, IL 61801
Phone (217) 383-3507

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190160000000",
    "number": "1649466186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 N LINCOLN AVE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012432",
            "telephone_number": "217-383-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 N LINCOLN AVE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012432",
            "telephone_number": "217-383-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLE CLINIC ASSOCIATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2007-09-19",
        "status": "A",
        "authorized_official_last_name": "MOBERG",
        "authorized_official_first_name": "KIRK",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "217-337-4105",
        "authorized_official_credential": "M.D, PH.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; 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.