NPIMap

Organization Active NPI

Vine St Clinic

  • Psychiatry Physician
  • Springfield, IL
National Provider Identifier
1730217662
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
VINE ST CLINIC
Practice address
3225 Hedley Rd
Springfield, IL 62711-6248
Phone
(217) 726-7300
Fax
(217) 726-5989
NPI assigned
Mar 1, 2007
Last updated
Apr 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Authorized official

Name
Dr. Richard B Alexander, M.D.NPI 1972632438
Title
Partner
Phone
(217) 726-7300

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary
Geriatric Psychiatry Physician 2084P0805X

Addresses

Primary practice location

3225 Hedley Rd
Springfield, IL 62711-6248

Mailing address

3225 Hedley Rd
PO Box 13484
Springfield, IL 62711-6248
Phone (217) 726-7300

Other identifiers 2

IdentifierTypeStateIssuer
08415473OtherILBLUE CROSS BLUE SHIELD
CL5057OtherGARAILROAD MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1730217662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 HEDLEY RD",
            "address_2": "PO BOX 13484",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116248",
            "telephone_number": "217-726-7300",
            "fax_number": "217-726-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 HEDLEY RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116248",
            "telephone_number": "217-726-7300",
            "fax_number": "217-726-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINE ST CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "217-726-7300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "08415473",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CL5057",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.