NPIMap

Organization Active NPI

Community College District 536

  • Family Nurse Practitioner
  • Godfrey, IL
National Provider Identifier
1679758387
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
COMMUNITY COLLEGE DISTRICT 536
Practice address
5800 Godfrey Rd
Fobes 1525
Godfrey, IL 62035-2426
Phone
(618) 468-6800
NPI assigned
Jan 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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

Authorized official

Name
Mr. Dale Chapman
Title
President
Phone
(618) 468-4440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

5800 Godfrey Rd
Fobes 1525
Godfrey, IL 62035-2426

Mailing address

5800 Godfrey Rd
Godfrey, IL 62035-2426
Phone (618) 468-4440

Other names 1

  • Lewis & Clark Family Health Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

5800 Godfrey Rd
Godfrey, IL 62035
Phone (618) 468-4440

5800 Godfrey Rd
#L106
Godfrey, IL 62035

5800 Godfrey Rd
#1525
Godfrey, IL 62035
Phone (618) 468-6800

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455667200000",
    "number": "1679758387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 GODFREY RD",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "620352426",
            "telephone_number": "618-468-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 GODFREY RD",
            "address_2": "FOBES 1525",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "620352426",
            "telephone_number": "618-468-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COLLEGE DISTRICT 536",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2016-02-17",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-468-4440",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lewis & Clark Family Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Godfrey, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; 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.