NPIMap

Organization Active NPI

Julia Rackley Perry Memorial Hospital

  • Durable Medical Equipment & Medical Supplies
  • Princeton, IL
National Provider Identifier
1891726253
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
20300268 Issued in IL
Legal business name
JULIA RACKLEY PERRY MEMORIAL HOSPITAL
Practice address
530 Park Ave E
Princeton, IL 61356-3901
Phone
(815) 876-3068
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Authorized official

Name
Patricia Ellison
Title
Cfo/Vice President
Phone
(815) 876-4497

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 20300268 IL Primary

Addresses

Primary practice location

530 Park Ave E
Princeton, IL 61356-3901

Mailing address

530 Park Ave E
Princeton, IL 61356-3901
Phone (815) 876-3068

Other identifiers 1

IdentifierTypeStateIssuer
621311OtherILBLUE CROSS BLUE SHIELD IL

Other names 1

  • Perry Home Medical Supply Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1891726253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 PARK AVE E",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613563901",
            "telephone_number": "815-876-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 PARK AVE E",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613563901",
            "telephone_number": "815-876-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIA RACKLEY PERRY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CFO/VICE PRESIDENT",
        "authorized_official_telephone_number": "815-876-4497"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "20300268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "621311",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perry Home Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Princeton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.