NPIMap

Organization Active NPI

Central Counties Health Centers, Inc.

  • Family Medicine Physician
  • Springfield, IL
National Provider Identifier
1669520177
Registry record updated Sep 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CENTRAL COUNTIES HEALTH CENTERS, INC.
Practice address
430 N 5TH St
St John'S Breadline
Springfield, IL 62702-5202
Phone
(217) 788-2300
Fax
(217) 788-2343
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2010

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

Authorized official

Name
Cindy Kavanagh
Title
Accountant
Phone
(217) 788-2300

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

430 N 5TH St
St John'S Breadline
Springfield, IL 62702-5202

Mailing address

2239 E Cook St
HCH - St John'S Breadline
Springfield, IL 62703-1944
Phone (217) 788-2300

Other names 1

  • Capitol Community Health Center - St John's Breadline Doing business as

National Provider Directory

National Provider Directory

Locations

430 N 5th St
Springfield, IL 62702
Phone (217) 528-6098

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285027200000",
    "number": "1669520177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2239 E COOK ST",
            "address_2": "HCH - ST JOHN'S BREADLINE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627031944",
            "telephone_number": "217-788-2300",
            "fax_number": "217-788-2343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 N 5TH ST",
            "address_2": "ST JOHN'S BREADLINE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025202",
            "telephone_number": "217-788-2300",
            "fax_number": "217-788-2343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL COUNTIES HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2010-09-21",
        "status": "A",
        "authorized_official_last_name": "KAVANAGH",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "ACCOUNTANT",
        "authorized_official_telephone_number": "217-788-2300"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capitol Community Health Center - St John's Breadline",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; 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.