NPIMap

Organization Active NPI

JCH Diaysis Center, LLC

Doing business as Jersey Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Jerseyville, IL
National Provider Identifier
1669698452
Registry record updated Mar 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
JCH DIAYSIS CENTER, LLC
Doing business as
Jersey Dialysis Center
Practice address
917 S State St
Jerseyville, IL 62052-2344
Phone
(618) 498-6402
NPI assigned
Apr 18, 2007
Organization subpart
Yes
Parent organization
BLESSING HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2009

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

Authorized official

Name
Mrs. Lorrie A Haden
Title
Director Revenu Cycle Management
Phone
(217) 223-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

917 S State St
Jerseyville, IL 62052-2344

Mailing address

917 S State St
Jerseyville, IL 62052-2344
Phone (618) 498-6402

Other identifiers 1

IdentifierTypeStateIssuer
50353OtherILBLUE CROSS

Other names 1

  • Jersey Dialysis Center Doing business as

National Provider Directory

National Provider Directory
Part of
Blessing Hosp Cardiolog

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

917 S State St
Jerseyville, IL 62052
Phone (618) 498-6402

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238112000000",
    "number": "1669698452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 S STATE ST",
            "city": "JERSEYVILLE",
            "state": "IL",
            "postal_code": "620522344",
            "telephone_number": "618-498-6402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 S STATE ST",
            "city": "JERSEYVILLE",
            "state": "IL",
            "postal_code": "620522344",
            "telephone_number": "618-498-6402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JCH DIAYSIS CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLESSING HOSPITAL",
        "enumeration_date": "2007-04-18",
        "last_updated": "2009-03-27",
        "status": "A",
        "authorized_official_last_name": "HADEN",
        "authorized_official_first_name": "LORRIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR REVENU CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "217-223-8400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "50353",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jersey Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jerseyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2009; 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.