Heartland Medical Center LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036100162 Issued in IL

Legal business name

HEARTLAND MEDICAL CENTER LLC

Practice address

5032 N Illinois St
Suite B
Fairview Heights, IL 62208-3415

Phone

(618) 416-9005

Fax

(618) 641-9452

NPI assigned

Jul 20, 2006

Organization subpart

No

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

Authorized official

Name

Benedicta Umoru, MDNPI 1003836446

Title

Physician

Phone

(618) 416-9005

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Benedicta Umoru, MD

  • Internal Medicine Physician
  • Fairview Heights, IL
  • NPI 1003836446
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463097600000",
    "number": "1912927351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2015",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622080215",
            "telephone_number": "618-355-9970",
            "fax_number": "618-355-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5032 N ILLINOIS ST",
            "address_2": "SUITE B",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622083415",
            "telephone_number": "618-416-9005",
            "fax_number": "618-641-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2016-05-13",
        "status": "A",
        "authorized_official_last_name": "UMORU",
        "authorized_official_first_name": "BENEDICTA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "618-416-9005",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036100162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DD7462",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100162",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "08232145",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zakiya Marie Harris
• Jillian Kira-Ruth Hayden, PTA
• Tymlyn Haynes
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• Heart to Sole, Inc
• Helfrich Family Eye Care, LLC
• Tara Helfrich, NP
• Carlene Ann Hempen, LCSW
• Nicholas Patrick Hepler, QMHP
• Shamika Shante' Herrington-King, CRSS

• Internal Medicine Physician in Fairview Heights, IL
• Providers in Fairview Heights, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; 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.