NPIMap

Organization Active NPI

Granite City Hospitalist Services LLC

  • Hospitalist Physician
  • Carbondale, IL
National Provider Identifier
1669926424
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
GRANITE CITY HOSPITALIST SERVICES LLC
Practice address
2250 N Illinois Ave
Carbondale, IL 62901-5612
Phone
(618) 833-1691
NPI assigned
Aug 10, 2016
Last updated
Jan 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Authorized official

Name
Daniel Doolittle, MDNPI 1912957051
Title
Ceo
Phone
(618) 833-1691

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X Primary

Addresses

Primary practice location

2250 N Illinois Ave
Carbondale, IL 62901-5612

Mailing address

2250 N Illinois Ave
Carbondale, IL 62901-5612
Phone (618) 833-1691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161006000282 IL Part B Supplier - Clinic/Group Practice 8527356591 Receives reassigned benefits from 96 practitioners
Practice locations: Granite City, IL; Anna, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 97

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.

View all 97

NPI Registry JSON

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485216000000",
    "number": "1669926424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 N ILLINOIS AVE",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015612",
            "telephone_number": "618-833-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 N ILLINOIS AVE",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015612",
            "telephone_number": "618-833-1691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANITE CITY HOSPITALIST SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-10",
        "last_updated": "2017-01-24",
        "status": "A",
        "authorized_official_last_name": "DOOLITTLE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "618-833-1691",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.