COMMUNITY MEDICAL CLINIC OF NOKOMIS
NPI 1114388733
Family Medicine in Nokomis, IL

Active since March 09, 2016CLIA 14D1077529 · Waiver
120 S CEDAR ST, NOKOMIS, IL 62075(217) 563-8363(217) 563-8373 Get Directions Write a Review

NPPES record last updated: March 9, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Community Medical Clinic Of Nokomis NPPES

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

COMMUNITY MEDICAL CLINIC OF NOKOMIS (NPI 1114388733) is a healthcare organization registered as a family medicine in Nokomis, Illinois and active in the NPI registry since March 2016. The organization holds a CLIA Waiver certificate valid through December 11, 2027 and lists Lisa Bloemer, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1114388733
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePANA COMMUNITY HOSPITAL ASSOCIATION
Location Address120 S CEDAR STNokomis, IL 62075-1647
Mailing Address120 S Cedar StNokomis, IL 62075-1647 · (217) 563-8363 · Fax (217) 563-8373
Fax(217) 563-8373
Organization SubpartYesParent: Community Medical Clinic Of Nokomis
Authorized OfficialLisa BloemerPractice Manager · (217) 562-6246
Enumeration DateMarch 9, 2016
NPI 1114388733 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

120 S CEDAR ST, Nokomis, IL 62075

Other Names 1

Doing Business AsCommunity Medical Clinic Of Nokomis

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 14D1077529

Community Medical Clinic Of Nokomis · Nokomis, IL
Active · expires Dec 11, 2027
CLIA Number14D1077529
Laboratory TypePhysician Office
Certificate Effective DateDecember 12, 2025
Certificate Expiration DateDecember 11, 2027
Laboratory DirectorWalter H. Cunnington
Laboratory Phone(217) 563-8363
Laboratory LocationCommunity Medical Clinic Of Nokomis120 Cedar St, Nokomis, IL 62075
CLIA data matches this NPI record on: Name 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.

Clinic/Center (Rural Health)
120 S CEDAR ST
NOKOMIS, IL 62075
Family Medicine
120 S CEDAR ST
NOKOMIS, IL 62075

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 Pana Community Hospital Association's NPI number?

The NPI number for Pana Community Hospital Association is 1114388733. It was assigned to this organization in the NPPES registry on March 9, 2016. The provider is doing business as Community Medical Clinic Of Nokomis.

Where is Pana Community Hospital Association located?

Pana Community Hospital Association is located at 120 S Cedar St, Nokomis, IL 62075. The listed phone number is (217) 563-8363.

What is Pana Community Hospital Association's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Pana Community Hospital Association hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D1077529) is associated with this NPI, valid through December 11, 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 Pana Community Hospital Association was last updated on March 9, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.