CARLE HEALTH CARE INCORPORATED (NPI# 1336482025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336482025 |
| Entity Type | Organization |
| Organization Name | CARLE HEALTH CARE INCORPORATED |
| Other Organization Name | CARLE PHYSICIAN GROUP |
| Practice Address |
602 W University Ave Urbana IL 61801-2530 |
| Mailing Address |
611 W Park St Urbana IL 61801-2500 |
| Practice Telephone | 2173838300 |
| Mailing Telephone | 2173836792 |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2013-04-01 |
| Authorized Official Name | MR. JOHN SNYDER (VICE CHAIRMAN) |
| Authorized Official Telephone | 2173834604 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE RR | DQ3650 | 01 |
| Other Name | Type Code |
|---|---|
| Carle Physician Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710398383 | Carle Health Care Incorporated | Durable Medical Equipment & Medical Supplies | 2512 Hurst Dr, Mattoon, IL 61938-9200 | 2014-05-16 |
| 1629341011 | Carle Health Care Incorporated | Hearing Aid Equipment | 709 W University Ave, Urbana, IL 61801-1765 | 2012-02-15 |
| 1124320700 | Carle Health Care Incorporated | Durable Medical Equipment & Medical Supplies | 200 Lerna Rd S, Mattoon, IL 61938-9388 | 2010-12-02 |
| 1821305871 | Carle Health Care Incorporated | Durable Medical Equipment & Medical Supplies | 611 W Park St, Urbana, IL 61801-2500 | 2010-09-10 |
| 1477860427 | Carle Health Care Incorporated | Durable Medical Equipment & Medical Supplies | 912 N Henrietta St, Effingham, IL 62401-1788 | 2010-09-10 |
| 1437465325 | Carle Health Care Incorporated | Durable Medical Equipment & Medical Supplies | 1 Memorial Dr, Physicians Plaza East, Suite 300, Decatur, IL 62526-6303 | 2010-08-30 |
| 1215254297 | Carle Health Care Incorporated | Durable Medical Equipment & Medical Supplies | 200 Lerna Rd S, Mattoon, IL 61938-9388 | 2010-04-29 |
| 1336464957 | Carle Health Care Incorporated | Family Medicine | 301 E Southline Rd, Tuscola, IL 61953-2014 | 2010-04-07 |
| 1154646776 | Carle Health Care Incorporated | Internal Medicine | 311 W Fairchild St, Danville, IL 61832-3876 | 2010-04-07 |
| 1851615926 | Carle Health Care Incorporated | Durable Medical Equipment & Medical Supplies | 1702 S Mattis Ave, Champaign, IL 61821-5469 | 2010-03-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CARLE HEALTH CARE INCORPORATED | 611 W Park St, Urbana, IL 61801-2529 |
| Street Address |
602 W UNIVERSITY AVE |
| City | URBANA |
| State | IL |
| Zip Code | 61801-2530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932194016 | Michael Shane Hennesy | Obstetrics & Gynecology | 602 W University Ave, Urbana, IL 61801-2530 | 2005-09-15 |
| 1265043996 | Brett E Smith | Pharmacist | 602 W University Ave, Urbana, IL 61801-2530 | 2020-08-14 |
| 1457753337 | Caroline Hudoba | Pharmacist | 602 W University Ave, Urbana, IL 61801-2530 | 2014-09-22 |
| 1124456363 | Nolan Jenkins | Dentist | 602 W University Ave, Urbana, IL 61801-2530 | 2013-10-25 |
| 1093147043 | Stephanie Freeman | Nurse Anesthetist, Certified Registered | 602 W University Ave, Urbana, IL 61801-2530 | 2013-08-01 |
| 1376988949 | Vanadhi Kannan | Nurse Anesthetist, Certified Registered | 602 W University Ave, Urbana, IL 61801-2530 | 2013-05-08 |
| 1427397884 | Hannah M Balow | Nurse Practitioner | 602 W University Ave, Urbana, IL 61801-2530 | 2013-02-05 |
| 1427309020 | Kathleen Voelker | Nurse Practitioner | 602 W University Ave, Urbana, IL 61801-2530 | 2012-09-24 |
| 1144575598 | Nathan V Mcclelland | Nurse Anesthetist, Certified Registered | 602 W University Ave, Urbana, IL 61801-2530 | 2012-07-20 |
| 1902189608 | Janet S Roadcap | Pharmacist | 602 W University Ave, Urbana, IL 61801-2530 | 2011-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1568090900 | Luke Andrew Fenlon | Student in an Organized Health Care Education/Training Program | Carle Forum Lower Level, Mc-474, 611 West Park Street, Urbana, IL 61801 | 2020-03-31 |
| 1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
| 1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
| 1093236002 | Angela Lynn Devaney | Speech-Language Pathologist | 1400 W Park, Presence Covenant Medical Center, Urbana, IL 61801 | 2017-06-29 |
| 1346775236 | Jennifer Garcia | Student in an Organized Health Care Education/Training Program | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2017-04-27 |
| 1467992537 | Amber Kristine Davis | Speech-Language Pathologist | 1400 W. Park, Presence Health Medical Center, Urbana, IL 61801 | 2017-03-08 |
| Find all providers in zip 61801 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
| 1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
| 1720500432 | James Skinner | Internal Medicine | 611 W Park St # Mc-474, Urbana, IL 61801-2529 | 2017-07-13 |
| 1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
| 1245751676 | Manushi Aggarwal | Internal Medicine | 611 W Park St # 474, Urbana, IL 61801-2529 | 2017-07-06 |
| 1710437470 | Fnu Shakuntulla | Internal Medicine | 1400 W Park St, Urbana, Urbana, IL 61801 | 2016-10-06 |
| 1124473111 | Nina Amilineni | Internal Medicine | 611 West Park St., North Clinic East 2, Urbana, IL 61801 | 2016-04-27 |
| 1619383064 | Urooj Fatima | Internal Medicine | 611 West Park St.,carle Forum Ll, Urbana, IL 61801 | 2014-07-07 |
| 1265874838 | Vinodkumar Chandrasekaran | Internal Medicine | 611 West Park St, Carle Hospital, Urbana, IL 61801 | 2013-07-24 |
| Find all providers in URBANA | ||||
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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.