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HEARTLAND PEDIATRIC CLINIC
NPI 1053413740
Clinic/Center - Rural Health in Marion, IL

Active since September 02, 2006CLIA 14D1013451 · Waiver
1000 W DEYOUNG ST, MARION, IL 62959(618) 993-5274(618) 999-0639 Get Directions Write a Review

NPPES record last updated: September 1, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 1, 2020, Mar 6, 2019, Aug 17, 2018 (3 updates tracked since 2018).

About Heartland Pediatric Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEARTLAND PEDIATRIC CLINIC (NPI 1053413740) is a healthcare organization registered as a rural health in Marion, Illinois and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through June 9, 2027 and lists Luis Alberto Lopez, President/physician, as its authorized official.

NPPES Registry Identity

NPI1053413740
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameHEARTLAND PEDIATRIC CLINIC
Location Address1000 W DEYOUNG STMarion, IL 62959-1630
Mailing AddressPo Box 1866Marion, IL 62959-8066 · (618) 993-5274 · Fax (618) 993-0639
Phone(618) 993-5274
Fax(618) 999-0639
Organization SubpartNo
Authorized OfficialLuis Alberto LopezPresident/physician · (618) 993-5274
Enumeration DateSeptember 2, 2006
Last NPPES UpdateSeptember 1, 20203 updates tracked since enumeration
NPPES CertifiedSeptember 1, 2020
✔ NPI 1053413740 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedPediatricsTaxonomy 208000000X
1000 W DEYOUNG ST, Marion, IL 62959
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D1013451

Heartland Pediatric Assoc · Marion, IL
Active · expires Jun 9, 2027
CLIA Number14D1013451
Laboratory TypePhysician Office
Certificate Effective DateJune 10, 2025
Certificate Expiration DateJune 9, 2027
Laboratory DirectorLuis Lopez
Laboratory Phone(618) 993-5274
Laboratory LocationHeartland Pediatric Assoc1000 W Deyoung St, Marion, IL 62959
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EYE SPECIALIST OF SOUTHERN ILLINOIS, LLC
Ophthalmology
1000 W DEYOUNG ST
MARION, IL 62959
Williamson County (618) 993-0068
DR. LUIS A LOPEZ M.D.
Pediatrics
1000 W DEYOUNG ST
MARION, IL 62959
Williamson County (618) 993-5274

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Heartland Pediatric Clinic's NPI number?

The NPI number for Heartland Pediatric Clinic is 1053413740. It was assigned to this organization in the NPPES registry on September 2, 2006.

Where is Heartland Pediatric Clinic located?

Heartland Pediatric Clinic is located at 1000 W Deyoung St, Marion, IL 62959. The listed phone number is (618) 993-5274.

What is Heartland Pediatric Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Heartland Pediatric Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D1013451) is associated with this NPI, valid through June 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Heartland Pediatric Clinic was last updated on September 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.