Organization Active NPI

Familia First Health NFP

  • Family Medicine Physician
  • Champaign, IL
National Provider Identifier
1871208074
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILIA FIRST HEALTH NFP
Practice address
1401 S State St
Suite B
Champaign, IL 61820
Phone
(217) 721-5080
NPI assigned
Jan 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

Name
Carrie Keenan, PA-C
Title
Coo
Phone
(217) 637-1310

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

1401 S State St
Suite B
Champaign, IL 61820

Mailing address

PO Box 2403
Champaign, IL 61825
Phone (772) 559-5878

Other names 1

  • Familia First Health Former legal business name

National Provider Directory

National Provider Directory

Locations

1401 S State St
Ste B
Champaign, IL 61820
Phone (217) 351-2021

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": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1871208074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2403",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "61825",
            "telephone_number": "772-559-5878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S STATE ST",
            "address_2": "SUITE B",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "61820",
            "telephone_number": "217-721-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILIA FIRST HEALTH NFP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2024-07-22",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "KEENAN",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "217-637-1310",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Familia First Health",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.