Carle Clinic Association, PC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CARLE CLINIC ASSOCIATION, PC

Practice address

2300 N Vermilion St
Danville, IL 61832-1735

Phone

(217) 431-7900

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Kirk Moberg, M.D., PH.D.

Title

Senior Vice President

Phone

(217) 383-3311

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1720119290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N VERMILION ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618321735",
            "telephone_number": "217-431-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N VERMILION ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618321735",
            "telephone_number": "217-431-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLE CLINIC ASSOCIATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "MOBERG",
        "authorized_official_first_name": "KIRK",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "217-383-3311",
        "authorized_official_credential": "M.D., PH.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Canciller, PHARMD
• Deanna L Cannon
• Latonya Carey-Wright, PSYD.
• Carle Clinic Association
• Carle Clinic Association, PC
• Carle Clinic Association, PC
• Carle Foundation Hospital
• Carle Health Care Incorporated
• Carle Health Care Incorporated
• Carle Health Care Incorporated

• Durable Medical Equipment & Medical Supplies in Danville, IL
• Providers in Danville, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.