NPIMap

Organization Active NPI

Poolside Health & Wellness Center

  • Rehabilitation Clinic/Center
  • Danville, IL
National Provider Identifier
1699832683
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
13304532 Issued in IL
Legal business name
POOLSIDE HEALTH & WELLNESS CENTER
Practice address
3733 Poolside Dr
Danville, IL 61832-1144
Phone
(217) 446-9283
Fax
(217) 442-2181
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Patricia A Owens
Title
Director of Patient Accounting
Phone
(217) 326-2911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X 13304532 IL Primary

Addresses

Primary practice location

3733 Poolside Dr
Danville, IL 61832-1144

Mailing address

611 W Park St
Urbana, IL 61801-2500
Phone (217) 326-2911

Other identifiers 3

IdentifierTypeStateIssuer
515838OtherILHEALTHLINK PROVIDER ID
075432OtherILHAMP PROVIDER ID
09232013OtherBLUE CROSS PROVIDER ID

National Provider Directory

National Provider Directory

Locations

3733 Poolside Dr
Danville, IL 61832
Phone (217) 326-2911

Practitioners & affiliated clinicians

Practitioners 6

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": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699832683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-326-2911",
            "fax_number": "217-344-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3733 POOLSIDE DR",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618321144",
            "telephone_number": "217-446-9283",
            "fax_number": "217-442-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POOLSIDE HEALTH & WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT ACCOUNTING",
        "authorized_official_telephone_number": "217-326-2911",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "IL",
            "license": "13304532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PROVIDER ID",
            "identifier": "515838",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAMP PROVIDER ID",
            "identifier": "075432",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER ID",
            "identifier": "09232013",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.