NPIMap

Organization Active NPI

Carle Clinic Association, PC

  • Durable Medical Equipment & Medical Supplies
  • Urbana, IL
National Provider Identifier
1801048541
Registry record updated Oct 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
060009889 Issued in IL
Legal business name
CARLE CLINIC ASSOCIATION, PC
Practice address
1818 E Windsor Rd
Urbana, IL 61802-9566
Phone
(217) 255-9636
NPI assigned
Oct 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2008

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

Authorized official

Name
Kirk Moberg, MD, PHD
Title
Senior Vice President
Phone
(217) 337-4105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 060009889 IL Primary

Addresses

Primary practice location

1818 E Windsor Rd
Urbana, IL 61802-9566

Mailing address

1818 E Windsor Rd
Urbana, IL 61802-9566
Phone (217) 255-9636

National Provider Directory

National Provider Directory
Tax ID family
Carle Clinic Association PC10 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.

Locations

1818 E Windsor Rd
Urbana, IL 61802
Phone (217) 255-9646

NPI Registry JSON

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223942400000",
    "number": "1801048541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 E WINDSOR RD",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618029566",
            "telephone_number": "217-255-9636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 E WINDSOR RD",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618029566",
            "telephone_number": "217-255-9636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLE CLINIC ASSOCIATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-14",
        "last_updated": "2008-10-14",
        "status": "A",
        "authorized_official_last_name": "MOBERG",
        "authorized_official_first_name": "KIRK",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "217-337-4105",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "060009889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2008; 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.