Siu Physicians & Surgeons, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SIU PHYSICIANS & SURGEONS, INC

Doing business as

SIU HealthCare

Practice address

315 W Carpenter St
Springfield, IL 62702-4901

Phone

(217) 545-5817

Fax

(217) 545-1141

NPI assigned

Mar 31, 2011

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jerry KruseNPI 1902883663

Title

Ceo

Phone

(217) 545-7876

Specialties & licenses 5

Addresses

Other names 1

• SIU HealthCare Doing business as

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Siu Physicians & Surgeons, Inc.

  dba Southern Illinois Family Medicine

  • Rural Health Clinic/Center
  • Carbondale, IL
  • NPI 1508924093

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerry E Kruse, M.D.

  • Family Medicine Physician
  • Quincy, IL
  • NPI 1902883663
  Authorized official Same address or phone

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1871882787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-7578",
            "fax_number": "217-545-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024901",
            "telephone_number": "217-545-5817",
            "fax_number": "217-545-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIU PHYSICIANS & SURGEONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-31",
        "last_updated": "2022-07-21",
        "certification_date": "2021-02-11",
        "status": "A",
        "authorized_official_last_name": "KRUSE",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-545-7876"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SIU HealthCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Siu Physicians & Surgeons, Inc (SIU HealthCare)
• Siu Physicians & Surgeons, Inc
• Siu Physicians & Surgeons, Inc
• Siu Physicians & Surgeons, Inc
• Siu Physicians & Surgeons, Inc (SIU Center for Diabetes and Metabolic Health)
• Siu Physicians & Surgeons, Inc
• Peyton Six, BCBA
• Linda K Skaggs, OGNP
• Savannah Skeeters
• Kara Skorge, CGC

• Community/Retail Pharmacy in Springfield, IL
• Providers in Springfield, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.