NPIMap

Organization Active NPI

Ferrell Hospital Community Foundation

Doing business as locust street clinic

  • Physician Assistant
  • Eldorado, IL
National Provider Identifier
1760625669
Registry record updated Apr 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
FERRELL HOSPITAL COMMUNITY FOUNDATION
Doing business as
locust street clinic
Practice address
1407 Locust St
Eldorado, IL 62930-1629
Phone
(618) 273-3361
Fax
(618) 273-5501
NPI assigned
Apr 8, 2009
Last updated
Apr 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2009

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

Authorized official

Name
H William Hartley
Title
Ceo/Administrator
Phone
(618) 473-3361

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1407 Locust St
Eldorado, IL 62930-1629

Mailing address

1407 Locust St
Eldorado, IL 62930-1629
Phone (618) 273-3361

Other names 1

  • locust street clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ferrell Hospital Family Practice10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239148800000",
    "number": "1760625669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 LOCUST ST",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629301629",
            "telephone_number": "618-273-3361",
            "fax_number": "618-273-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 LOCUST ST",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629301629",
            "telephone_number": "618-273-3361",
            "fax_number": "618-273-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERRELL HOSPITAL COMMUNITY FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-08",
        "last_updated": "2009-04-08",
        "status": "A",
        "authorized_official_last_name": "HARTLEY",
        "authorized_official_first_name": "H",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "618-473-3361"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "locust street clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eldorado, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.