Active NPI
Granite City Hospitalist Services LLC
- Hospitalist Physician
- Carbondale, IL
National Provider Identifier
1669926424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- 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
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Daniel Doolittle, MD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryPractitioners & affiliated clinicians
Practitioners 97
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
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- NPI 1811085293
IL
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.