Carle Clinic Association, PC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

060009052 Issued in IL

Legal business name

CARLE CLINIC ASSOCIATION, PC

Practice address

4000 Green Apple Lane
Monticello, IL 61856-1175

Phone

(217) 762-2518

NPI assigned

Mar 7, 2007

Last updated

Sep 4, 2009By 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

Kirk Moberg

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": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252022400000",
    "number": "1730219627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 GREEN APPLE LANE",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618561175",
            "telephone_number": "217-762-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 GREEN APPLE LANE",
            "city": "MONTICELLO",
            "state": "IL",
            "postal_code": "618561175",
            "telephone_number": "217-762-2518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLE CLINIC ASSOCIATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2009-09-04",
        "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"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "060009052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Benson, MS, RDN, LDN
• Shelli Jo Billingsley, LPC
• Jacob Blasingame, PA-C
• Dawn Brazzell, APRN, FNP-BC
• Rachel Caldwell, CCC-SLP
• Carle Foundation Hospital (Carle RX Express)
• Carle Health Care Incorporated (Carle Physician Group)
• Carle RX Express Pharmacy
• Christie Clinic, LLC
• Jessica Clapp, LCSW

• Durable Medical Equipment & Medical Supplies in Monticello, IL
• Providers in Monticello, 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 Sep 4, 2009; 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.