SARAH BUSH LINCOLN HEALTH CENTER (NPI# 1043338189) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043338189 |
| Entity Type | Organization |
| Organization Name | SARAH BUSH LINCOLN HEALTH CENTER |
| Other Organization Name | FAMILY MEDICAL CENTER IM |
| Practice Address |
200 Richmond Ave E Mattoon IL 61938-4652 |
| Mailing Address |
1000 Health Center Dr Mattoon IL 61938-9253 |
| Practice Telephone | 2172355471 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-07-18 |
| Authorized Official Name | MR. DENNIS PLUARD (CFO) |
| Authorized Official Telephone | 2172582591 |
| Is Organization Subpart | Y |
| Parent Organization Name | SARAH BUSH LINCOLN HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0000X |
Internal Medicine Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Family Medical Center IM | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386283455 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 1611 Veterans Ave Ste T, Vandalia, IL 62471-3303 | 2020-01-06 |
| 1467951699 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 903 N Maple St, Effingham, IL 62401 | 2018-02-02 |
| 1215436449 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 300 Coles Centre Pkwy, Mattoon, IL 61938 | 2018-02-02 |
| 1346368487 | Sarah Bush Lincoln Health Center | Pediatrics | 1411 E St, Suite 2, Charleston, IL 61920-2529 | 2007-03-27 |
| 1528186665 | Sarah Bush Lincoln Health Center | Clinic/Center | 934 North Route 49, Casey, IL 62420 | 2007-03-27 |
| 1467570507 | Sarah Bush Lincoln Health Center | Family Medicine | 200 Professional Plz, Mattoon, IL 61938-9280 | 2007-03-27 |
| 1386762425 | Sarah Bush Lincoln Health Center | Family Medicine | 104 Courthouse Square, Toledo, IL 62468 | 2007-03-27 |
| 1588782627 | Sarah Bush Lincoln Health Center | Family Medicine | 1005 Health Center Drive, Suite 103, Prairie Pavilion I, Mattoon, IL 61938-4693 | 2007-03-27 |
| 1083732630 | Sarah Bush Lincoln Health Center | Family Medicine | 241 W Springfield Rd, Arcola, IL 61910-1202 | 2007-03-26 |
| 1922190024 | Sarah Bush Lincoln Health Center | Home Health | 1004 Health Center Dr, Suite 202, Mattoon, IL 61938-9253 | 2006-09-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SARAH BUSH LINCOLN HEALTH CENTER | 1000 Health Center Dr, Mattoon, IL 61938-9253 |
| Street Address |
200 RICHMOND AVE E |
| City | MATTOON |
| State | IL |
| Zip Code | 61938-4652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558386961 | Douglas Kabbes | Emergency Medicine | 200 Richmond Ave E, Mattoon, IL 61938 | 2006-07-13 |
| 1942741038 | Sarah Bush Lincoln Health Center | Psychiatry & Neurology | 200 Richmond Ave E, Suite 3, Mattoon, IL 61938-4652 | 2017-03-09 |
| 1700281342 | Angelia Stewart | Nurse Practitioner | 200 Richmond Ave E, Mattoon, IL 61938-4652 | 2014-10-24 |
| 1396148458 | Allison T. Alumbaugh | Nurse Practitioner | 200 Richmond Ave E, Mattoon, IL 61938-4652 | 2014-10-03 |
| 1700215928 | Lori A. Nottmeyer | Nurse Practitioner | 200 Richmond Ave E, Mattoon, IL 61938-4652 | 2013-11-07 |
| 1689994014 | Amanda M Bramham | Family Medicine | 200 Richmond Ave E, Mattoon, IL 61938-4652 | 2010-06-08 |
| 1952429094 | Sarah Bush Lincoln Health Center | Family Medicine | 200 Richmond Ave E, Mattoon, IL 61938-4652 | 2007-03-27 |
| 1962520007 | Sarah Bush Lincoln Health Center | Family Medicine | 200 Richmond Ave E, Mattoon, IL 61938-4652 | 2007-03-27 |
| 1285737213 | Robert Andrew Thain | Family Medicine | 200 Richmond Ave E, Mattoon, IL 61938-4652 | 2006-09-06 |
| 1962518746 | Gary Mikel | Family Medicine | 200 Richmond Ave E, Mattoon, IL 61938-4652 | 2006-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043831134 | St Anthony's Memorial Hospital of The Hospital Sisters of The Third Or | Clinic/Center | 101 Coles Centre Pkwy, Ste 101, Mattoon, IL 61938 | 2020-04-30 |
| 1215436449 | Sarah Bush Lincoln Health Center | Durable Medical Equipment & Medical Supplies | 300 Coles Centre Pkwy, Mattoon, IL 61938 | 2018-02-02 |
| 1841707726 | Mattoon Chiropractic LLC | Chiropractor | 905 Remington Rd, Mattoon, IL 61938 | 2018-01-02 |
| 1164892758 | Dr. Charles L. Schnibben Ltd. | Dentist | 1502 Lakeland Blvd, Mattoon, IL 61938 | 2015-09-25 |
| 1982000139 | Judy A. Clark | Hearing Instrument Specialist | 1302 Charleston Avenue, Audibel Hearing Aids, Mattoon, IL 61938 | 2014-11-17 |
| 1023419884 | Christopher Steven Lillie | Physician Assistant | 200 Richmond Ave East, Family Medical Center, Mattoon, IL 61938 | 2014-09-11 |
| 1295055168 | Jennifer Harp | Mechanotherapist | 232 Richmond Ave East, Mattoon, IL 61938 | 2010-06-02 |
| 1447482682 | Gene Clark Hearing Aid Service | Hearing Aid Equipment | 208 Wabash, Mattoon, IL 61938 | 2009-08-21 |
| 1326229774 | Central Illinois Family Health Center | Nurse Practitioner | 10555 East County Rd 800 North, Mattoon, IL 61938 | 2007-11-14 |
| 1568656445 | Bernie Ranchero | Family Medicine | 1004 Health Center Dr Ste 210, Mattoon, IL 61938 | 2007-09-04 |
| Find all providers in zip 61938 | ||||
| Taxonomy Code | 207RA0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Adolescent Medicine |
| An internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447446257 | Farah Tazeen | Internal Medicine | 1 S 161 Summit Ave., Oak Brook Terrace, IL 60181-3904 | 2007-09-15 |
| 1114142643 | Christina B Nulty | Internal Medicine | 912 N Elmwood Ave, Peoria, IL 61625-0001 | 2007-04-17 |
| 1679665020 | Lynessa A Alonso | Internal Medicine | 10 Saint Clare Ct, Washington, IL 61571-9239 | 2006-09-29 |
| 1447273859 | Samir Shah M.d.s.c | Internal Medicine | 3560 W 95th St, Evergreen Park, IL 60805-2107 | 2006-07-26 |
| 1194248914 | Mohamed Ihtesham Shaji | Internal Medicine | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2017-07-24 |
| 1679969182 | Greg D Ewert Md Sc | Internal Medicine | 200 S Michigan Ave, Suite 805, Chicago, IL 60604-2402 | 2015-04-10 |
| 1437599867 | Shakuntala Sachin Patil | Internal Medicine | 611 W Park St, Carle Forum Ll, Urbana, IL 61801-2500 | 2013-06-29 |
| 1487993911 | Eilis Ryan | Internal Medicine | 6500 W 65th St, Chicago, IL 60638-4962 | 2013-02-04 |
| 1831496322 | Capital Health Inc | Internal Medicine | 7107 W Belmont Ave, Suite 8, Chicago, IL 60634-4688 | 2011-02-17 |
| 1356507834 | Woodridgeclinic S.c | Internal Medicine | 805 S Main St, Lombard, IL 60148-3300 | 2008-08-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.