County of Clark

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6-6745 Issued in IL

Legal business name

COUNTY OF CLARK

Practice address

501 Archer Ave
Marshall, IL 62441-1275

Phone

(217) 382-4642

Fax

(217) 382-4676

NPI assigned

Mar 20, 2007

Last updated

Mar 20, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sheri Higginbotham

Title

County Treasurer

Phone

(217) 826-5721

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• County of Clark

  • Public Health or Welfare Agency
  • Martinsville, IL
  • NPI 1396821237

  7517063225

  Same PAC ID

Tax ID family

Clark County Health Department2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• County of Clark

  • Public Health or Welfare Agency
  • Martinsville, IL
  • NPI 1396821237
  NPD tax ID

Locations

Practitioners 3

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.

• Cathy Hayden

  • Community Health Worker
  • Martinsville, IL
  • NPI 1811350697
  NPD (past)
• Steven Macke, MD

  • Family Medicine Physician
  • Marshall, IL
  • NPI 1609867373
  NPD (past)
• Valerie Marie Mullen, RN

  • Community Health Registered Nurse
  • Martinsville, IL
  • NPI 1861855744
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1710002589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 ARCHER AVE",
            "city": "MARSHALL",
            "state": "IL",
            "postal_code": "624411275",
            "telephone_number": "217-382-4642",
            "fax_number": "217-382-4676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 ARCHER AVE",
            "city": "MARSHALL",
            "state": "IL",
            "postal_code": "624411275",
            "telephone_number": "217-382-4642",
            "fax_number": "217-382-4676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF CLARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "HIGGINBOTHAM",
        "authorized_official_first_name": "SHERI",
        "authorized_official_title_or_position": "COUNTY TREASURER",
        "authorized_official_telephone_number": "217-826-5721"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "6-6745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Brown, MS, ATC
• Burnsides Community Health Center
• Burnsides Community Health Center, NFP (Burnsides Community Health Center)
• Jessica Nicole Cannady, CCC-SLP
• Core Wellness Physical Therapy, PLLC
• Barbara Michelle Edwards, LCSW, CADAC III MATS
• Anita Yvonne Eirhart, LMT
• Jessica Lynn Engledow, CCC-SLP
• Eyes on Main PLLC
• Tabitha Hanson, DMD

• Land Ambulance in Marshall, IL
• Providers in Marshall, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; 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.

Verify at the official NPI Registry.