St Joseph Medical Center

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

Legal business name

ST JOSEPH MEDICAL CENTER

Doing business as

HeartCare Midwest

Practice address

1505 Eastland Dr
Suite 110
Bloomington, IL 61701-3534

Phone

(309) 663-9800

NPI assigned

Oct 11, 2006

Last updated

Mar 14, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

OSF HEALTHCARE SYSTEMAs reported in NPPES

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

Authorized official

Name

Robert C. Sehring

Title

Ceo Osf Healthcare System

Phone

(309) 665-2850

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• HeartCare Midwest Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

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

• St Joseph Medical Center

  dba Cancer Care Associates

  • Radiation Oncology Physician
  • Normal, IL
  • NPI 1174758346

  O20040129001106

  Same enrollment
• St Joseph Medical Center

  dba OSF Saint Joseph Medical Center

  • General Acute Care Hospital
  • Bloomington, IL
  • NPI 1619916806

  O20040129001106

  Same enrollment
• St Joseph Medical Center

  dba OSF Saint Joseph Medical Center

  • Emergency Medicine Physician
  • Bloomington, IL
  • NPI 1659552859

  O20040129001106

  Same enrollment
• St Joseph Medical Center

  dba OSFMG - Bloomington

  • Family Medicine Physician
  • Bloomington, IL
  • NPI 1871547414

  O20040129001106

  Same enrollment

Part of

Eastland Med Plaza Surg

Locations

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1881782878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 SW ADAMS ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021308",
            "telephone_number": "309-655-2850",
            "fax_number": "309-655-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 EASTLAND DR",
            "address_2": "SUITE 110",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013534",
            "telephone_number": "309-663-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPH MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OSF HEALTHCARE SYSTEM",
        "enumeration_date": "2006-10-11",
        "last_updated": "2024-03-14",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "SEHRING",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CEO OSF HEALTHCARE SYSTEM",
        "authorized_official_telephone_number": "309-665-2850"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "057-32087",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HeartCare Midwest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• St Joseph Medical Center
• St Joseph Medical Center (OSF Saint Joseph Medical Center)
• St Joseph Medical Center (OSF Saint Joseph Medical Center)
• St Joseph Medical Center (OSF Home Health-Eastern Region)
• St Joseph Medical Center (OSFMG - Bloomington)
• St Joseph Medical Center (St Joseph Medical Center Occupational Health)
• St Joseph Medical Center (OSF Saint Joseph Medical Center)
• St. Joseph Medical Center (OSF Hospice-Eastern Region)
• Richard Lee Stallman, R.PH
• Kyle Stang, MD

• Interventional Cardiology Physician in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Interventional Cardiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; 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.