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COULTERVILLE MEDICAL CLINIC
NPI 1083721567
Clinic/Center - Rural Health in Coulterville, IL

Active since August 23, 2006CLIA Certified · 2 labs
203 E GRANT ST, COULTERVILLE, IL 62237(618) 758-2331(618) 758-2819 Get Directions Write a Review

NPPES record last updated: May 16, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 16, 2023, Aug 21, 2018, Jun 8, 2017 (3 updates tracked since 2017).

About Coulterville Medical Clinic NPPES

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

COULTERVILLE MEDICAL CLINIC (NPI 1083721567) is a healthcare organization registered as a rural health in Coulterville, Illinois and active in the NPI registry since August 2006. The organization holds 2 active CLIA laboratory certificates and lists Lisa Ernsting, Cfo, as its authorized official.

NPPES Registry Identity

NPI1083721567
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameSPARTA COMMUNITY HOSPITAL D/B/A QUALITY HEALTHCARE CLINICS
Location Address203 E GRANT STCoulterville, IL 62237-1623
Mailing AddressPo Box 297Sparta, IL 62286-0297 · (618) 443-1337 · Fax (618) 443-1383
Phone(618) 758-2331
Fax(618) 758-2819
Organization SubpartNo
Authorized OfficialLisa ErnstingCfo · (618) 443-2177
Enumeration DateAugust 23, 2006
Last NPPES UpdateMay 16, 20233 updates tracked since enumeration
NPPES CertifiedMay 16, 2023
✔ NPI 1083721567 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
203 E GRANT ST, Coulterville, IL 62237
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Other Names 1

Other NameCoulterville Medical Clinic

Other Identifiers 1

Other143465IL · Rhc Provider Location Num

CLIA Laboratory Certificates CMS CLIA 2

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 for Provider-Performed Microscopy Procedures (PPMP) 14D0889678

Sparta Community Hospital D/B/A Quality Health Care Clinics · Coulterville, IL
Active · expires Feb 21, 2027
CLIA Number14D0889678
Laboratory TypePhysician Office
Certificate Effective DateFebruary 22, 2025
Certificate Expiration DateFebruary 21, 2027
Laboratory DirectorShawn D. Beckemeyer MD
Laboratory Phone(618) 758-2331
Laboratory LocationSparta Community Hospital D/B/A Quality Health Care Clinics203 East Grant, Coulterville, IL 62237
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Accreditation 14D0434503

Sparta Community Hospital · Sparta, IL
Active · expires Feb 27, 2027
CLIA Number14D0434503
Laboratory TypeHospital
Certificate Effective DateFebruary 28, 2025
Certificate Expiration DateFebruary 27, 2027
Laboratory DirectorDr. Olaronke Akintola-Ogunremi
Laboratory Phone(618) 443-1472
Laboratory LocationSparta Community Hospital818 E Broadway - PO Box 297, Sparta, IL 62286
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 3

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

SHAWN BECKEMEYER MD
Family Medicine
203 E GRANT ST
COULTERVILLE, IL 62237
Randolph County (618) 758-2331
DANIELLE RENEE PREUSS PA-C
Physician Assistant
203 E GRANT ST
COULTERVILLE, IL 62237
Randolph County (618) 758-2331
ASHLEY N HUNDELT FNP-BC
Nurse Practitioner (Family)
203 E GRANT ST
COULTERVILLE, IL 62237
Randolph County (618) 758-2331

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 Sparta Community Hospital D/B/A Quality Healthcare Clinics's NPI number?

The NPI number for Sparta Community Hospital D/B/A Quality Healthcare Clinics is 1083721567. It was assigned to this organization in the NPPES registry on August 23, 2006. The provider is also known as Coulterville Medical Clinic.

Where is Sparta Community Hospital D/B/A Quality Healthcare Clinics located?

Sparta Community Hospital D/B/A Quality Healthcare Clinics is located at 203 E Grant St, Coulterville, IL 62237. The listed phone number is (618) 758-2331.

What is Sparta Community Hospital D/B/A Quality Healthcare Clinics's specialty?

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

Does Sparta Community Hospital D/B/A Quality Healthcare Clinics hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Sparta Community Hospital D/B/A Quality Healthcare Clinics was last updated on May 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.