Passavant Memorial Area Hospital Association

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION

Doing business as

Passavant Area Hospital

Practice address

1600 W Walnut St
Jacksonville, IL 62650-1136

Phone

(217) 245-9541

Fax

(217) 479-8781

NPI assigned

Aug 22, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

MEMORIAL HEALTH SYSTEMAs reported in NPPES

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

Authorized official

Name

Mr. Harry M Schmidt

Title

President and Ceo

Phone

(217) 245-9541

Specialties & licenses 8

Addresses

Other names 1

• Passavant Area Hospital Doing business as

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1689780520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501136",
            "telephone_number": "217-245-9541",
            "fax_number": "217-479-8781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501136",
            "telephone_number": "217-245-9541",
            "fax_number": "217-479-8781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL HEALTH SYSTEM",
        "enumeration_date": "2006-08-22",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "HARRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "217-245-9541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Passavant Area Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Passavant Memorial Area Hospital Association (Jacksonville Professional Fees)
• Passavant Memorial Area Hospital Association (Passavant Area Hospital IPU)
• Passavant Memorial Area Hospital Association
• Passavant Memorial Area Hospital Association
• Passavant Memorial Area Hospital Association
• Passavant Memorial Area Hospital Association (Passavant Professional Services)
• Passavant Physician Association
• Passavant Physician Association (Passavant Internal Medicine Rural Health Clinic)
• Passavant Physician Association (Wound Clinic RHC)
• Passavant Physician Association

• Family Medicine Physician in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.