DESOTO CCSD 86 (NPI# 1225200850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225200850 |
| Entity Type | Organization |
| Organization Name | DESOTO CCSD 86 |
| Other Organization Name | DESOTO CONS SCHOOL DISTRICXT 86 |
| Practice Address |
311 Hurst Rd De Soto IL 62924-1228 |
| Practice Telephone | 6188672317 |
| Practice Fax Number | 6188673233 |
| Mailing Telephone | 6188672317 |
| Mailing Fax Number | 6188673233 |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MR. MARK EDWARD BULLOCK (SUPERINTENDENT) |
| Authorized Official Telephone | 6188672317 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS1000X |
Clinic/Center Specialization: Student Health |
IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| DeSoto Cons School Districxt 86 | Other Name - Individual/Organization |
| Street Address |
311 HURST RD |
| City | DE SOTO |
| State | IL |
| Zip Code | 62924-1228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700904216 | Desoto Cons School District 86 | Clinic/Center | 311 Hurst Rd, De Soto, IL 62924-1228 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750947586 | Kaitlyn Maloney | Physical Medicine & Rehabilitation | 125 Jan Ln Apt 2, De Soto, IL 62924-0045 | 2019-05-16 |
| 1184829996 | Thomas W. Kupferer, D.o. | Clinic/Center | 407 S Chestnut St, De Soto, IL 62924-1400 | 2007-06-20 |
| 1396100269 | Skystar Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 406 E Douglas St, De Soto, IL 62924-1516 | 2015-12-21 |
| 1700495819 | Meghan Jo Shackleton | Nurse Practitioner | 204 N Reed Station Rd, De Soto, IL 62924-1612 | 2020-07-24 |
| 1871844415 | Pam Collins | Developmental Therapist | 1371 Leo Ln, De Soto, IL 62924-2220 | 2012-09-22 |
| 1366681397 | Louisette C. Plath | Psychologist | 151 Vaughn Rd, De Soto, IL 62924-3445 | 2009-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700495819 | Meghan Jo Shackleton | Nurse Practitioner | 204 N Reed Station Rd, De Soto, IL 62924-1612 | 2020-07-24 |
| 1558986000 | Christy Lynn Pashia | Counselor | 116 N 2nd St # B, De Soto, MO 63020-1701 | 2020-06-10 |
| 1356963060 | Joshua Lee Lahr | Physician Assistant | 33345 W 87th Ter, De Soto, KS 66018-7952 | 2020-05-15 |
| 1912557844 | Gabriela Marie Garza | Physician Assistant | 10160 Waverly Rd, De Soto, KS 66018-7996 | 2019-09-12 |
| 1700435385 | Patsy Maness | Technician | 5100 Knorpp Road, De Soto, MO 63020 | 2019-09-06 |
| 1184272668 | Savanah Santonge | Technician | 608 Perry St, De Soto, MO 63020-1136 | 2019-08-28 |
| 1982250494 | Laura J Peek | Pathology | 8960 Commerce Dr Bldg 6, De Soto, KS 66018-8433 | 2019-08-12 |
| 1528610946 | Korinne Elizabeth Sackett | Pharmacist | 2020 Rock Rd, De Soto, MO 63020-1052 | 2019-07-15 |
| 1326608985 | Rachel Meyer | Speech-Language Pathologist | 650 Vineland School Rd, De Soto, MO 63020-2561 | 2019-06-17 |
| 1043877004 | Reilly Schultz | Case Management | 31505 W 85th St, De Soto, KS 66018-7804 | 2019-05-24 |
| Find all providers in DE SOTO | ||||
| Taxonomy Code | 261QS1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Student Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700904216 | Desoto Cons School District 86 | Clinic/Center | 311 Hurst Rd, De Soto, IL 62924-1228 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811409196 | Gavin School District 37 | Clinic/Center | 25775 W Highway 134, Ingleside, IL 60041-9587 | 2017-10-26 |
| 1053822080 | Northestern Illinois University Student Health Services | Clinic/Center | 5500 N Saint Louis Ave Rm E-051, Chicago, IL 60625-4625 | 2017-10-17 |
| 1871905190 | The Board of Trustees of The University of Illinois | Clinic/Center | 840 Blackhawk Blvd, South Beloit, IL 61080-2263 | 2014-05-21 |
| 1043630098 | Mcgaw Medical Center of Northwestern University | Clinic/Center | 240 E. Huron Street, Mcgaw Pavilion, Sutie 1-200, Chicago, IL 60611 | 2014-04-17 |
| 1407284664 | Pef Clinic II, Ltd. | Clinic/Center | 1955 E 75th St, Chicago, IL 60649-3688 | 2013-10-28 |
| 1508294091 | South Shore School of Leadership Health Center | Clinic/Center | 7627 S Constance Ave, Chicago, IL 60649-4009 | 2013-10-22 |
| 1659705150 | Circle Family Healthcare Network | Clinic/Center | 4701 Harrison St, Hillside, IL 60162-1616 | 2013-09-03 |
| 1932441946 | The Board of Trustees of Siu Governing Siue | Clinic/Center | Student Success Ctr Rm 0222, Campus Box 1055, Edwardsville, IL 62026-1055 | 2013-03-18 |
| 1225378094 | Kankakee School District 111 | Clinic/Center | 1200 W Jeffery St, Kankakee, IL 60901-4667 | 2013-02-15 |
| 1033478383 | Rockford School District | Clinic/Center | 401 N Gardiner Ave, Rockford, IL 61107-4338 | 2012-05-07 |
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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.