Active NPI
Katherine Shaw Bethea Hospital
- Medicare Defined Swing Bed Hospital Unit
- Dixon, IL
National Provider Identifier
1962600072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medicare Defined Swing Bed Hospital Unit
- License
- 0000497
- Legal business name
- KATHERINE SHAW BETHEA HOSPITAL
- Practice address
- 403 E 1St St
Dixon, IL 61021-3116 - Phone
- (815) 288-5531
- Fax
- (815) 285-5688
- NPI assigned
- Jul 10, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Darryl Vandervort
- Title
- Ceo
- Phone
- (815) 285-5501
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | 0000497 | IL | Primary |
Addresses
Primary practice location
403 E 1St St
Dixon, IL 61021-3116
Mailing address
403 E 1St St
Dixon, IL 61021-3116
Phone (815) 288-5531
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1962600072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "403 E 1ST ST",
"city": "DIXON",
"state": "IL",
"postal_code": "610213116",
"telephone_number": "815-288-5531",
"fax_number": "815-285-5688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 E 1ST ST",
"city": "DIXON",
"state": "IL",
"postal_code": "610213116",
"telephone_number": "815-288-5531",
"fax_number": "815-285-5688"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KATHERINE SHAW BETHEA HOSPITAL",
"organizational_subpart": "NO",
"enumeration_date": "2007-07-10",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "VANDERVORT",
"authorized_official_first_name": "DARRYL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "815-285-5501"
},
"taxonomies": [
{
"code": "275N00000X",
"taxonomy_group": "",
"desc": "Medicare Defined Swing Bed Unit",
"state": "IL",
"license": "0000497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dixon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.