NPIMap

Organization Active NPI

Trinity Medical Staffing LLC

  • Internal Medicine Physician
  • Harrisburg, IL
National Provider Identifier
1770103426
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TRINITY MEDICAL STAFFING LLC
Practice address
100 Dr Warren Tuttle Dr
Harrisburg, IL 62946-2718
Phone
(618) 253-7671
NPI assigned
Apr 23, 2020
Last updated
Sep 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Caleb Sutton
Title
Director of Organizational DVLP
Phone
(618) 833-1691

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946-2718

Mailing address

2250 N Illinois Ave
Carbondale, IL 62901-5612

Other practice location 1

611 S Marshall Ave
Mc Leansboro, IL 62859-1213
Phone (618) 643-2631

Other practice location 2

200 E Fairman Ave
Watseka, IL 60970-1644
Phone (815) 432-5841

Other practice location 3

911 Stacey Burk Dr
Flora, IL 62839-3241
Phone (618) 662-2131

Other practice location 4

28 Chick St
Metropolis, IL 62960-2467
Phone (618) 427-2680

Other practice location 5

400 Maple Summit Rd
Jerseyville, IL 62052-2028
Phone (618) 498-6402

Other practice location 6

8 Doctors Park Rd
Mount Vernon, IL 62864-6224
Phone (618) 244-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200511000598 IL Part B Supplier - Clinic/Group Practice 1759712698 Receives reassigned benefits from 67 practitioners
Practice locations: Harrisburg, IL; Jerseyville, IL; MC Leansboro, IL; Metropolis, IL; Mount Vernon, IL; Watseka, IL

National Provider Directory

National Provider Directory

Locations

2250 N Illinois Ave
Carbondale, IL 62901
Phone (618) 833-1691

Practitioners & affiliated clinicians

Practitioners 68

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.

View all 68

NPI Registry JSON

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1770103426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 N ILLINOIS AVE",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DR WARREN TUTTLE DR",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629462718",
            "telephone_number": "618-253-7671"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 S Marshall Ave",
            "address_purpose": "LOCATION",
            "city": "Mc Leansboro",
            "state": "IL",
            "postal_code": "628591213",
            "country_code": "US",
            "telephone_number": "618-643-2631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 E Fairman Ave",
            "address_purpose": "LOCATION",
            "city": "Watseka",
            "state": "IL",
            "postal_code": "609701644",
            "country_code": "US",
            "telephone_number": "815-432-5841",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "911 Stacey Burk Dr",
            "address_purpose": "LOCATION",
            "city": "Flora",
            "state": "IL",
            "postal_code": "628393241",
            "country_code": "US",
            "telephone_number": "618-662-2131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "28 Chick St",
            "address_purpose": "LOCATION",
            "city": "Metropolis",
            "state": "IL",
            "postal_code": "629602467",
            "country_code": "US",
            "telephone_number": "618-427-2680",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Maple Summit Rd",
            "address_purpose": "LOCATION",
            "city": "Jerseyville",
            "state": "IL",
            "postal_code": "620522028",
            "country_code": "US",
            "telephone_number": "618-498-6402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8 Doctors Park Rd",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "IL",
            "postal_code": "628646224",
            "country_code": "US",
            "telephone_number": "618-244-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRINITY MEDICAL STAFFING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-23",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "CALEB",
        "authorized_official_title_or_position": "DIRECTOR OF ORGANIZATIONAL DVLP",
        "authorized_official_telephone_number": "618-833-1691"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.