S B Jani MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

S B JANI MD PC

Practice address

1106 Oak St
Mount Carmel, IL 62863-2444

Phone

(618) 263-6575

Fax

(618) 262-4468

NPI assigned

Jan 25, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Siddharth B Jani, M.D.

Title

Owner

Phone

(618) 263-6575

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Wabash General Hospital District

  • Rural Health Clinic/Center
  • Mount Carmel, IL
  • NPI 1114491875

  Sold to, 2019-07-01

  CMS change of ownership

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1952588642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 OAK ST",
            "city": "MOUNT CARMEL",
            "state": "IL",
            "postal_code": "628632444",
            "telephone_number": "618-263-6575",
            "fax_number": "618-262-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 OAK ST",
            "city": "MOUNT CARMEL",
            "state": "IL",
            "postal_code": "628632444",
            "telephone_number": "618-263-6575",
            "fax_number": "618-262-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S B JANI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-25",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "JANI",
        "authorized_official_first_name": "SIDDHARTH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-263-6575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Mount Carmel, IL
• Providers in Mount Carmel, 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 Apr 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.