NPIMap

Organization Active NPI

Carbondale Elem School

  • Student Health Clinic/Center
  • Carbondale, IL
National Provider Identifier
1972774156
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
CARBONDALE ELEM SCHOOL
Practice address
925 S Giant City Rd
Carbondale, IL 62902-5056
Phone
(618) 457-3591
Fax
(618) 457-4411
NPI assigned
Mar 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mr. John K Williams
Title
Assistant Superintendent
Phone
(618) 457-3591

Specialties & licenses 1

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

Addresses

Primary practice location

925 S Giant City Rd
Carbondale, IL 62902-5056

Mailing address

925 S Giant City Rd
Carbondale, IL 62902-5056
Phone (618) 457-3591

Other names 1

  • Carbondale Elem Sch Dist 95 Other name

National Provider Directory

National Provider Directory
Tax ID family
Carbondale Elem SCH Dist 952 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

925 S Giant City Rd
Carbondale, IL 62902
Phone (618) 457-3591

Practitioners & affiliated clinicians

Practitioners 3

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": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1972774156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 S GIANT CITY RD",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629025056",
            "telephone_number": "618-457-3591",
            "fax_number": "618-457-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 S GIANT CITY RD",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629025056",
            "telephone_number": "618-457-3591",
            "fax_number": "618-457-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARBONDALE ELEM SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "ASSISTANT SUPERINTENDENT",
        "authorized_official_telephone_number": "618-457-3591",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carbondale Elem Sch Dist 95",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.