NPIMap

Organization Active NPI

HSHS Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Havana, IL
National Provider Identifier
1790172583
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
HSHS MEDICAL GROUP INC
Practice address
615 N Promenade St
Havana, IL 62644-1243
Phone
(217) 243-1101
Fax
(217) 243-5003
NPI assigned
Apr 20, 2015
Last updated
Apr 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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

Authorized official

Name
Melinda Clark, CEO
Title
Ceo
Phone
(217) 523-5406

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

615 N Promenade St
Havana, IL 62644-1243

Mailing address

3215 Executive Park Dr
Springfield, IL 62703-4514
Phone (217) 523-5406

National Provider Directory

National Provider Directory
Tax ID family
HSHS Medical Group18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429488000000",
    "number": "1790172583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3215 EXECUTIVE PARK DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627034514",
            "telephone_number": "217-523-5406",
            "fax_number": "217-492-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N PROMENADE ST",
            "city": "HAVANA",
            "state": "IL",
            "postal_code": "626441243",
            "telephone_number": "217-243-1101",
            "fax_number": "217-243-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HSHS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-20",
        "last_updated": "2015-04-20",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-523-5406",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havana, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.