Immediate Convenient Care-Perryville, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

IMMEDIATE CONVENIENT CARE-PERRYVILLE, LLC

Practice address

1508 Edgemont Blvd
Perryville, MO 63775-1231

Phone

(573) 517-7555

Fax

(573) 517-7556

NPI assigned

Apr 22, 2011

Last updated

Apr 22, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

SAINT FRANCIS HEALTHCARE SYSTEMSAs reported in NPPES

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

Authorized official

Name

William Anthony Balsano

Title

VP Financial Affairs

Phone

(573) 331-5228

Specialties & licenses 1

Addresses

Part of

St Francis Medical Cent

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303430400000",
    "number": "1851682025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 N KINGSHIGHWAY ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012122",
            "telephone_number": "573-339-2000",
            "fax_number": "573-339-1876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 EDGEMONT BLVD",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751231",
            "telephone_number": "573-517-7555",
            "fax_number": "573-517-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMEDIATE CONVENIENT CARE-PERRYVILLE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAINT FRANCIS HEALTHCARE SYSTEMS",
        "enumeration_date": "2011-04-22",
        "last_updated": "2011-04-22",
        "status": "A",
        "authorized_official_last_name": "BALSANO",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "VP FINANCIAL AFFAIRS",
        "authorized_official_telephone_number": "573-331-5228"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Elizabeth Hotop, FNP-C
• Maegyn Huber
• Natalie Huber, DPT
• Jonathan Hudak, LPC, NCC, MA
• Joseph David Hutchison, D.D.S.
• Immediate Healthcare, Inc.
• Independence Health System, Inc.
• Katie Marie Isgriggs, BS, HIS
• J.U.S.T. Orthotics
• Joe David Hutchison, D.D.S., P.C.

• Family Medicine Physician in Perryville, MO
• Providers in Perryville, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2011; 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.