Organization Active NPI

Springs of Healing LLC

  • Clinic/Center
  • Belleville, IL
National Provider Identifier
1902773450
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
Legal business name
SPRINGS OF HEALING LLC
Practice address
4104 N Park Dr
Belleville, IL 62226-5312
Phone
(732) 523-4057
NPI assigned
Oct 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Authorized official

Name
Oghenero OlomukoroNPI 1437899689
Title
Owner
Phone
(618) 978-0739

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WP0808X Primary
Clinic/Center 261Q00000X

Addresses

Primary practice location

4104 N Park Dr
Belleville, IL 62226-5312

Mailing address

4104 N Park Dr
Belleville, IL 62226-5312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251120000431 MO Part B Supplier - Clinic/Group Practice 3779075544 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1760918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789430400000",
    "number": "1902773450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4104 N PARK DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4104 N PARK DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265312",
            "telephone_number": "732-523-4057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGS OF HEALING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-20",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A",
        "authorized_official_last_name": "OLOMUKORO",
        "authorized_official_first_name": "OGHENERO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-978-0739"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; 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.