COMMUNITY CONS SCH DIST 204 (NPI# 1497978464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497978464 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CONS SCH DIST 204 |
| Other Organization Name | COMMUNITY CONSOLID SCH DIS 204 |
| Practice Address |
6067 State Route 154 Pinckneyville IL 62274-3414 |
| Practice Telephone | 6183572419 |
| Practice Fax Number | 6183573016 |
| Mailing Telephone | 6183572419 |
| Mailing Fax Number | 6183573016 |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MR. CHRIS RIGDON (SUPERINTENDENT) |
| Authorized Official Telephone | 6183572419 |
| 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 |
|---|---|
| Community Consolid Sch Dis 204 | Other Name - Individual/Organization |
| Street Address |
6067 STATE ROUTE 154 |
| City | PINCKNEYVILLE |
| State | IL |
| Zip Code | 62274-3414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922279280 | Community Consolid Sch Dis 204 | Clinic/Center | 6067 State Route 154, Pinckneyville, IL 62274-3414 | 2008-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912260233 | Kathy Lynn Heard | Physical Therapy Assistant | 101 N. Walnut St., Pinckneyville, IL 62274 | 2012-06-21 |
| 1235254350 | Timothy Alan Mathis | Emergency Medicine | 202 S Walnut St, Pinckneyville, IL 62274 | 2007-03-20 |
| 1225194988 | Perry County Trans Van | Non-emergency Medical Transport (VAN) | 602 S Douglas St, Pinckneyville, IL 62274 | 2006-12-28 |
| 1063591261 | Medical Arts Sc | Family Medicine | 13 North Walnut Street, Pinckneyville, IL 62274 | 2006-11-06 |
| 1588670426 | Ralph Kane Chapman | Dentist | Box 469, 314 W South St, Pinckneyville, IL 62274 | 2006-07-31 |
| 1427456961 | Alisa D Dearmond | Nurse Practitioner | 5383 State Route 154, Pinckneyville, IL 62274 | 2014-12-16 |
| 1619210721 | Andrea Marie Epplin | Nurse Practitioner | 5383 State Route 154, Family Medical Center, Pinckneyville, IL 62274 | 2013-03-27 |
| 1841336799 | Clinic Pharmacy | Pharmacy | 206 North Main Street, Pinckneyville, IL 62274-0364 | 2007-01-29 |
| 1992840821 | Wayne Ray Hawkins | Dentist | 212 N Walnut St, Pinckneyville, IL 62274-1015 | 2007-02-20 |
| 1194384669 | Thaddeus Hawkins | Dentist | 212 N Walnut St, Pinckneyville, IL 62274-1015 | 2019-06-10 |
| Find all providers in zip 62274 | ||||
| Taxonomy Code | 261QS1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Student Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205006129 | Pinckneyville School District #50 | Clinic/Center | 301 W Mulberry St, Pinckneyville, IL 62274-1370 | 2008-03-06 |
| 1588781785 | Pinckneyville Comm Hs Dist 101 | Clinic/Center | 600 E Water St, Pinckneyville, IL 62274-1472 | 2007-03-23 |
| 1932371275 | Pinckneyville High School | Clinic/Center | 600 E Water St, Pinckneyville, IL 62274-1472 | 2008-03-27 |
| 1922279280 | Community Consolid Sch Dis 204 | Clinic/Center | 6067 State Route 154, Pinckneyville, IL 62274-3414 | 2008-03-14 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | PINCKNEYVILLE |
| Zip Code | 62274 |
Please comment or provide details below to improve the information on COMMUNITY CONS SCH DIST 204.
| 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.