NPIMap

Organization Active NPI

National Healthcare of Mt Vernon Inc

  • Internal Medicine Physician
  • Benton, IL
National Provider Identifier
1902143910
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NATIONAL HEALTHCARE OF MT VERNON INC
Doing business as
Crossroads Family Medicine of Benton
Practice address
905 W Washington St
Suite a
Benton, IL 62812-1649
Phone
(618) 435-2229
Fax
(618) 435-2232
NPI assigned
Jan 10, 2013
Organization subpart
Yes
Parent organization
NATIONAL HEALTHCARE OF MT VERNON INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Authorized official

Name
James Wright
Title
Sr Director
Phone
(615) 465-7587

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

905 W Washington St
Suite a
Benton, IL 62812-1649

Mailing address

PO Box 689022
Franklin, TN 37068-9022
Phone (888) 422-1522

Other names 1

  • Crossroads Family Medicine of Benton Doing business as

National Provider Directory

National Provider Directory
Part of
Crossroads Comm Hosp

NPI Registry JSON

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

{
    "created_epoch": "1357776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426118400000",
    "number": "1902143910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022",
            "telephone_number": "888-422-1522",
            "fax_number": "615-628-6984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 W WASHINGTON ST",
            "address_2": "SUITE A",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121649",
            "telephone_number": "618-435-2229",
            "fax_number": "618-435-2232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL HEALTHCARE OF MT VERNON INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NATIONAL HEALTHCARE OF MT VERNON INC",
        "enumeration_date": "2013-01-10",
        "last_updated": "2015-03-12",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "SR DIRECTOR",
        "authorized_official_telephone_number": "615-465-7587"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Family Medicine of Benton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Benton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; 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.