NPIMap

Organization Active NPI

The Board of Trustees of Siu Governing Siue

  • Student Health Clinic/Center
  • Edwardsville, IL
National Provider Identifier
1932441946
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
THE BOARD OF TRUSTEES OF SIU GOVERNING SIUE
Practice address
Student Success Ctr RM 0222
Campus Box 1055
Edwardsville, IL 62026-1055
Phone
(618) 650-2850
Fax
(618) 650-5839
NPI assigned
Mar 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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

Authorized official

Name
Riane B Greenwalt
Title
Director, Health Service
Phone
(618) 650-2852

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

Student Success Ctr RM 0222
Campus Box 1055
Edwardsville, IL 62026-1055

Mailing address

Student Success Ctr RM 0222
Campus Box 1055
Edwardsville, IL 62026-1055
Phone (618) 650-2850

Other names 1

  • Department: SIUE Health Service Other name

National Provider Directory

National Provider Directory
Tax ID family
The Board of Trustees of Siu Governing Siue6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

Student Success Ctr
Rm 0222
Edwardsville, IL 62026
Phone (618) 650-2842

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364947200000",
    "number": "1932441946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "STUDENT SUCCESS CTR RM 0222",
            "address_2": "CAMPUS BOX 1055",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620261055",
            "telephone_number": "618-650-2850",
            "fax_number": "618-650-5839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STUDENT SUCCESS CTR RM 0222",
            "address_2": "CAMPUS BOX 1055",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620261055",
            "telephone_number": "618-650-2850",
            "fax_number": "618-650-5839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BOARD OF TRUSTEES OF SIU GOVERNING SIUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-18",
        "last_updated": "2013-04-03",
        "status": "A",
        "authorized_official_last_name": "GREENWALT",
        "authorized_official_first_name": "RIANE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR, HEALTH SERVICE",
        "authorized_official_telephone_number": "618-650-2852"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Department: SIUE Health Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Edwardsville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; 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.