Red Bud Regional Clinic Company LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

RED BUD REGIONAL CLINIC COMPANY LLC

Practice address

509 Hamacher St
Suite 103
Waterloo, IL 62298-1592

Phone

(618) 939-2273

Fax

(618) 939-0245

NPI assigned

Apr 7, 2015

Organization subpart

Yes

Parent organization

CHS/COMMUNITY HEALTH SYSTEMS, INCAs reported in NPPES

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

Authorized official

Name

Laura J Fey

Title

Sr. Director Physician Rev Cycle

Phone

(615) 221-3641

Specialties & licenses 1

Addresses

Part of

CHS Community Health Systems Inc

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1584/brand/1/csg/49/fhir/r4

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1992191951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1573 MALLORY LN STE 100",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272895",
            "telephone_number": "615-221-1400",
            "fax_number": "615-846-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 HAMACHER ST",
            "address_2": "SUITE 103",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981592",
            "telephone_number": "618-939-2273",
            "fax_number": "618-939-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED BUD REGIONAL CLINIC COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHS/COMMUNITY HEALTH SYSTEMS, INC",
        "enumeration_date": "2015-04-07",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A",
        "authorized_official_last_name": "FEY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SR. DIRECTOR PHYSICIAN REV CYCLE",
        "authorized_official_telephone_number": "615-221-3641"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Qualls, MHP
• Lance Edwin Qualmann, MA, QHMP
• Danielle Lynn Quintana, NP
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• Brooke Rey, MOT, OTR/L
• Chelsea Rheinecker, LPN, MHP

• Family Medicine Physician in Waterloo, IL
• Providers in Waterloo, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.