NPIMap

Organization Active NPI

Toofan Medical Holdings, LTD.

  • Rural Health Clinic/Center
  • Taylorville, IL
National Provider Identifier
1700380219
Registry record updated Mar 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
TOOFAN MEDICAL HOLDINGS, LTD.
Practice address
1510 W Springfield Rd Ste a
Taylorville, IL 62568-2764
Phone
(217) 824-8244
Fax
(217) 994-9304
NPI assigned
Mar 20, 2018
Last updated
Mar 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2018

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

Authorized official

Name
Dr. Paul A Toofan, MDNPI 1013989805
Title
President
Phone
(217) 994-9301

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
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

1510 W Springfield Rd Ste a
Taylorville, IL 62568-2764

Mailing address

1510 W Springfield Rd Ste a
Taylorville, IL 62568-2764
Phone (217) 824-8244

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180424001200 IL Part A Provider - Rural Health Clinic 6800026006 Practice locations: Taylorville, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700380219. Details of each certification follow.

Rural health clinic certification: CCN 783857

Legal name
TOOFAN MEDICAL HOLDINGS, LTD
Doing business as
TAYLORVILLE URGENT CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 26, 2022
Last certification
Sep 26, 2022
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Aug 3, 2013 in IL
Enrollment address
1510 W Springfield Rd
Ste a
Taylorville, IL 62568-2764

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Toofan Medical Holdings LTD8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
April N Toofan Individual Corporate OfficerSecretary Feb 1, 2014
Paul a Toofan Individual 5% Or Greater Direct Ownership InterestOwner Feb 1, 2014 100%
Corporate OfficerPresident Feb 1, 2014
W-2 Managing EmployeePresident Feb 1, 2014

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Paul A Toofan, M.D.
    • Emergency Medicine Physician
    • Effingham, IL
    • NPI 1013989805

    5% Or Greater Direct Ownership Interest, Corporate Officer, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521504000000",
    "number": "1700380219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 W SPRINGFIELD RD STE A",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625682764",
            "telephone_number": "217-824-8244",
            "fax_number": "217-994-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 W SPRINGFIELD RD STE A",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625682764",
            "telephone_number": "217-824-8244",
            "fax_number": "217-994-9304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOOFAN MEDICAL HOLDINGS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-20",
        "last_updated": "2018-03-20",
        "status": "A",
        "authorized_official_last_name": "TOOFAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-994-9301",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylorville, IL

Sources for this page

Verify at the official NPI Registry.