NPIMap

Organization Active NPI

Springfield Clinic LLP

Doing business as Springfield Clinic Decatur Lab

  • Clinical Medical Laboratory
  • Decatur, IL
National Provider Identifier
1902064900
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
SPRINGFIELD CLINIC LLP
Doing business as
Springfield Clinic Decatur Lab
Practice address
250 W Kenwood Ave
Decatur, IL 62526-4371
Phone
(217) 428-3424
NPI assigned
May 27, 2008
Last updated
Apr 18, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
SPRINGFIELD CLINIC LLPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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

Authorized official

Name
Mr. Alan Nerone
Title
Senior Vice President & Cfo
Phone
(217) 528-7541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

250 W Kenwood Ave
Decatur, IL 62526-4371

Mailing address

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

Other identifiers 1

IdentifierTypeStateIssuer
14D0706922OtherCLIA

Other names 1

  • Springfield Clinic Decatur Lab Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0706922Springfield Clinic Decatur250 W Kenwood, Decatur, IL 62526Certificate of waiverMay 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Taylorville Medical Associates Lab63 organizations share this tax ID, including this one
Part of
Taylorville Medical Associates Lab

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

Locations

250 W Kenwood Ave
Decatur, IL 62526
Phone (217) 872-3800

NPI Registry JSON

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524009600000",
    "number": "1902064900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W KENWOOD AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264371",
            "telephone_number": "217-428-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGFIELD CLINIC LLP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPRINGFIELD CLINIC LLP",
        "enumeration_date": "2008-05-27",
        "last_updated": "2018-04-18",
        "status": "A",
        "authorized_official_last_name": "NERONE",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT & CFO",
        "authorized_official_telephone_number": "217-528-7541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "14D0706922",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springfield Clinic Decatur Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.