NPIMap

Organization Active NPI

National Healthcare of Mt Vernon Inc

  • General Acute Care Hospital
  • Mount Vernon, IL
National Provider Identifier
1750353041
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
0003947 Issued in IL
Legal business name
NATIONAL HEALTHCARE OF MT VERNON INC
Practice address
8 Doctors Park Rd
Mount Vernon, IL 62864-6224
Phone
(618) 244-5500
Fax
(618) 244-5566
NPI assigned
Feb 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Authorized official

Name
Randy Michael Cooper
Title
SVP Finance Operations/Ao
Phone
(615) 221-3840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 0003947 IL Primary

Addresses

Primary practice location

8 Doctors Park Rd
Mount Vernon, IL 62864-6224

Mailing address

PO Box 60548
Saint Louis, MO 63160-0548

Other identifiers 4

IdentifierTypeStateIssuer
288089OtherHEALTHLINK
011701901MedicaidMO
131OtherBCBS
614753OtherBOILERMAKERS

Other names 1

  • Crossroads Community Hospital Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599091200000",
    "number": "1750353041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60548",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631600548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 DOCTORS PARK RD",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646224",
            "telephone_number": "618-244-5500",
            "fax_number": "618-244-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL HEALTHCARE OF MT VERNON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "SVP FINANCE OPERATIONS/AO",
        "authorized_official_telephone_number": "615-221-3840"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "0003947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "288089",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011701901",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "131",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOILERMAKERS",
            "identifier": "614753",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crossroads Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.