Pana Community Hospital Association
Organization Active NPI Family Medicine Physician · Nokomis, IL
NPI 1992994461 · NPPES record last updated Jan 31, 2008
Key facts
- NPI
- 1992994461
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- PANA COMMUNITY HOSPITAL ASSOCIATION
- Practice address
- 120 S Cedar St
Nokomis, IL 62075-1647 - Phone
- (217) 562-2544
- Fax
- (217) 562-6288
- NPI assigned
- Oct 19, 2007
- Organization subpart
- No
Authorized official
- Name
- Lisa Marie Bloemer
- Title
- Office Manager
- Phone
- (217) 562-2544
Other NPIs on the same Medicare enrollment 6
Corporate family (same tax ID) 16
Practitioners 20
-
Mollie Rae Beyers, PT, DPT
-
Aaron Brewer, M.D.
-
Luis J Caceres, M.D.
-
Holly Marie Chapman, APN
-
Roberto Garcia, MD
-
Saurabh Jha, M.D.
-
Robert G Ludwig II, CRNA
-
Schales Lucille Nagle, LCSW
-
Silvan Omerovic, DO
-
Nileshkumar J Patel, M.D.
-
Bharath Rajagopalan, M.B.,B.S
-
Coleen Karen Rakers, ANP-BC
-
Cindy Lea Rich, APN CNP
-
Ritika Sharma, M.D.
-
Jennifer Joyce Weekly, APRN, FNP-BC
-
Robert C Woodruff, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031121000350 | IL | Part B Supplier - Clinic/Group Practice | 3274437348 |
Receives reassigned benefits from 97 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Moweaqua, IL; Ramsey, IL; Pana, IL; Nokomis, IL |
National Provider Directory
- Tax ID family
- Pana Internal Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
120 S Cedar St
Nokomis, IL 62075-1647
Mailing address
120 S Cedar St
Nokomis, IL 62075-1647
Phone (217) 562-2544
Other names
- COMMUNITY MEDICAL CLINIC OF NOKOMIS
Other providers in Nokomis, IL
- Nokomis Medical Group
- Nokomis-Witt Area Ambulance Service
- Nokomis-Witt Area Ambulance Service Inc
- Pana Community Hospital Association
- Pana Community Hospital Association
- Pana Community Hosptial Association
- Petersen Health Care - Nokomis, LLC
- Petersen Health Network, LLC
- Robert Gollon
- Springfield Clinic, LLP
All providers in Nokomis, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.