Immanuel Health Center

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

IMMANUEL HEALTH CENTER

Practice address

502 S Morris Ave
Suite a
Bloomington, IL 61701-4884

Phone

(309) 824-7485

NPI assigned

Aug 18, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Trina Scott, M.D.

Title

Executive Director

Phone

(309) 824-7485

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313625600000",
    "number": "1669752960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3281",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617023281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 S MORRIS AVE",
            "address_2": "SUITE A",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617014884",
            "telephone_number": "309-824-7485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMANUEL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-18",
        "last_updated": "2011-08-18",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "TRINA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "309-824-7485",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.