NPIMap

Organization Active NPI

St Joseph Medical Center

Doing business as St Joseph Medical Center Occupational Health

  • Occupational Medicine Physician
  • Bloomington, IL
National Provider Identifier
1902066400
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
Legal business name
ST JOSEPH MEDICAL CENTER
Doing business as
St Joseph Medical Center Occupational Health
Practice address
1505 Eastland Dr
Suite 1000
Bloomington, IL 61701-3534
Phone
(309) 655-4905
NPI assigned
Jun 10, 2008
Last updated
Mar 14, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
OSF HEALTHCARE SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Authorized official

Name
Robert C. Sehring
Title
Ceo
Phone
(309) 655-2850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2083X0100X Primary

Addresses

Primary practice location

1505 Eastland Dr
Suite 1000
Bloomington, IL 61701-3534

Mailing address

124 SW Adams St
Peoria, IL 61602-1308
Phone (309) 655-2850

Other identifiers 1

IdentifierTypeStateIssuer
5715427OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • ST JOSEPH MEDICAL CENTER OCCUPATIONAL HEALTH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Josephs Hosp Med Ctr4 organizations share this tax ID, including this one
Part of
Osf Healthcare System

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1902066400",
    "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 1000",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013534",
            "telephone_number": "309-655-4905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPH MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OSF HEALTHCARE SYSTEM",
        "enumeration_date": "2008-06-10",
        "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",
        "authorized_official_telephone_number": "309-655-2850"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5715427",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST JOSEPH MEDICAL CENTER OCCUPATIONAL HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomington, IL

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.