PROTESTANT MEMORIAL MEDICAL CENTER, INC. (NPI# 1558979690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558979690 |
| Entity Type | Organization |
| Organization Name | PROTESTANT MEMORIAL MEDICAL CENTER, INC. |
| Practice Address |
4500 Memorial Dr Belleville IL 62226-5360 |
| Practice Telephone | 6182575613 |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2020-07-15 |
| Authorized Official Name | JANE KAREN GUSMANO (VICE PRESIDENT, CFO) |
| Authorized Official Telephone | 6182575607 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| Memorial Hospital Belleville | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568542850 | Protestant Memorial Medical Center, Inc. | Home Health | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2006-10-17 |
| 1285729210 | Protestant Memorial Medical Center, Inc. | Skilled Nursing Facility | 4315 Memorial Dr, Belleville, IL 62226-5342 | 2006-10-04 |
| Street Address |
4500 MEMORIAL DR |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226-5360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326045568 | Kenneth I Bluestone | Anesthesiology | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2005-07-01 |
| 1841815784 | Kayla Marie Tisza | Nurse Anesthetist, Certified Registered | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-06-16 |
| 1588289581 | Katie O'rourke | Nurse Anesthetist, Certified Registered | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-06-15 |
| 1518592203 | Daniela Vetan-zlibut | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-03-03 |
| 1396377289 | Kathryn Cook | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-02-07 |
| 1124650353 | Jessica Stricklin | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5399 | 2020-02-05 |
| 1396375788 | Emily Jean Sloan | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2020-01-24 |
| 1629639695 | Nicholas Raburn | Nurse Anesthetist, Certified Registered | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2019-06-21 |
| 1124582523 | Jenna Dornak | Physician Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2019-01-30 |
| 1093279432 | Dana Bennett | Occupational Therapy Assistant | 4500 Memorial Dr, Belleville, IL 62226-5360 | 2019-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902051154 | Eldercare, Inc. | Clinical Medical Laboratory | 727 North 17th Street, Belleville, IL 62226-6599 | 2008-12-01 |
| 1699706770 | Medical Diagnostic Laboratory, Inc | Clinical Medical Laboratory | 45 Sheffield Dr, Belleville, IL 62223-3557 | 2006-07-06 |
| 1366422032 | Health Ventures of Southern Illinois LLC | Clinical Medical Laboratory | 180 S Third St, Tri-lab LLC Ste 200, Belleville, IL 62220-1952 | 2006-01-19 |
| 1255311924 | Health Ventures of Southern Illinois Inc | Clinical Medical Laboratory | 33 Bronze Pointe, Ste 150, Belleville, IL 62226-8305 | 2006-01-19 |
| 1659351336 | Health Ventures of Southern Illinois LLC | Clinical Medical Laboratory | 211 S Third Street, Tri Lab LLC, Belleville, IL 62220-1915 | 2006-01-19 |
| 1386713964 | Laboratory Corporation of America | Clinical Medical Laboratory | 180 S 3rd St, Suite 200, Belleville, IL 62220-1952 | 2006-11-07 |
| 1164509840 | Laboratory Corporation of America | Clinical Medical Laboratory | 180 S 3rd St, Suite 300, Belleville, IL 62220-1952 | 2006-11-01 |
| 1922026970 | Quest Diagnostics Clinical Lab Inc. | Clinical Medical Laboratory | 2900 Frank Scott Pkwy W, Belleville, IL 62223-5000 | 2006-07-18 |
| 1669451977 | Health Ventures of Southern Illonois LLC | Clinical Medical Laboratory | 180 S 3rd St, Ste 300 Tri-lab LLC @ St Elizabeth's Medical Arts Build, Belleville, IL 62220-1952 | 2006-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745670 | Rivercross Diagnostics Inc. | Clinical Medical Laboratory | 910 Broadway St Ste Ab, Quincy, IL 62301-2729 | 2020-09-21 |
| 1952915506 | Vip Labs LLC. | Clinical Medical Laboratory | 2555 Lincoln Hwy Ste 104, Olympia Fields, IL 60461-1938 | 2020-09-01 |
| 1538770276 | Precision Phlebotomy Inc | Clinical Medical Laboratory | 9241 S Roberts Rd, Hickory Hills, IL 60457-3809 | 2020-08-15 |
| 1316558182 | Southwest Medical Solutions Inc | Clinical Medical Laboratory | 5533 W 109th St Ste 101, Oak Lawn, IL 60453-5058 | 2020-08-13 |
| 1083232946 | Sjs Medical Labs, LLC D/b/a Arcpoint Labs of Libertyville | Clinical Medical Laboratory | 1659 Northwind Blvd, Libertyville, IL 60048-9613 | 2020-07-08 |
| 1922625961 | Abil Corporation | Clinical Medical Laboratory | 1375 Remington Rd Ste A, Schaumburg, IL 60173-4844 | 2020-06-25 |
| 1588280622 | Radiance Biosciences and Consultancy, LLC | Clinical Medical Laboratory | 1260 Iroquois Ave Ste 302, Naperville, IL 60563-8549 | 2020-06-24 |
| 1417573916 | Global Medical Solutionz Equipment & Transportation Co. | Clinical Medical Laboratory | 1334 Central Park Dr Ste 3, O Fallon, IL 62269-1784 | 2020-06-19 |
| 1538781174 | Harmone Labs, LLC | Clinical Medical Laboratory | 1622 S Taylorville Rd, Decatur, IL 62521-3951 | 2020-05-16 |
| 1225659204 | Gist Entities, LLC | Clinical Medical Laboratory | 11006 W 179th St, Orland Park, IL 60467-9440 | 2020-05-01 |
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| City | BELLEVILLE |
| Zip Code | 62226 |
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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.