NPIMap

Organization Active NPI

Niemann Foods Inc

  • Community/Retail Pharmacy
  • Springfield, IL
National Provider Identifier
1821100769
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054016035 Issued in IL
Legal business name
NIEMANN FOODS INC
Practice address
1903 W Monroe St
Springfield, IL 62704-1530
Phone
(217) 787-2830
Fax
(217) 787-4520
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Authorized official

Name
Christopher Niemann
Title
Evp/Cfo
Phone
(217) 221-5612

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 054016035 IL Primary

Addresses

Primary practice location

1903 W Monroe St
Springfield, IL 62704-1530

Mailing address

PO Box C847
Quincy, IL 62306-0847
Phone (217) 221-5641

Other identifiers 1

IdentifierTypeStateIssuer
1479977OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • COUNTY MARKET PHARMACY 228 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211006002600 IL Part B Supplier - Mass Immunization (Roster Biller Only) 6103032206 9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Champaign, IL; Springfield, IL; Pittsfield, IL; Rushville, IL; Chatham, IL; Lewistown, IL

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1903 W Monroe St
Springfield, IL 62704
Phone (217) 787-0340

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1821100769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX C847",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623060847",
            "telephone_number": "217-221-5641",
            "fax_number": "217-221-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 W MONROE ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627041530",
            "telephone_number": "217-787-2830",
            "fax_number": "217-787-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIEMANN FOODS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "NIEMANN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "EVP/CFO",
        "authorized_official_telephone_number": "217-221-5612"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054016035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1479977",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COUNTY MARKET PHARMACY 228",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.