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BACKROAD HEALTH CARE INC
NPI 1134582018
Nurse Practitioner - Family in Centralia, IL

Active since March 30, 2016
211 S PERRINE AVE, CENTRALIA, IL 62801(618) 419-0011(888) 980-2931 Get Directions Write a Review

NPPES record last updated: March 18, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 18, 2019, Mar 30, 2016 (2 updates tracked since 2016).

About Backroad Health Care Inc NPPES

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

BACKROAD HEALTH CARE INC (NPI 1134582018) is a healthcare organization registered as a family in Centralia, Illinois and active in the NPI registry since March 2016. The organization maintains a secondary practice location in Walnut Hill and lists Paul S Havrilka, Fnp/owner, as its authorized official.

NPPES Registry Identity

NPI1134582018
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameBACKROAD HEALTH CARE INC
Location Address211 S PERRINE AVECentralia, IL 62801-3635
Mailing Address314 S Poplar St Unit 864Centralia, IL 62801-0848 · (618) 419-0011 · Fax (888) 960-2931
Phone(618) 419-0011
Fax(888) 980-2931
Organization SubpartNo
Authorized OfficialPaul S HavrilkaFnp/owner · (618) 419-0011
Enumeration DateMarch 30, 2016
Last NPPES UpdateMarch 18, 20192 updates tracked since enumeration
✔ NPI 1134582018 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
211 S PERRINE AVE, Centralia, IL 62801
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Secondary Practice Location 1

Location 17825A E Grant RdWalnut Hill, IL 62893-1613 · Phone (618) 545-0707 · Fax (888) 802-1633

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

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.

DR. STEPHANIE KAY SHOOK D.C.
Chiropractor
211 S PERRINE AVE
CENTRALIA, IL 62801
Marion County (307) 760-9999
DR. DANA LEE MATHIS D.C.
Chiropractor
211 S PERRINE AVE
CENTRALIA, IL 62801
Marion County (618) 533-2225
CRITTER CHIROPRACTIC INC.
Chiropractor
211 S PERRINE AVE
CENTRALIA, IL 62801
Marion County (618) 533-2225

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 Backroad Health Care Inc's NPI number?

The NPI number for Backroad Health Care Inc is 1134582018. It was assigned to this organization in the NPPES registry on March 30, 2016.

Where is Backroad Health Care Inc located?

Backroad Health Care Inc is located at 211 S Perrine Ave, Centralia, IL 62801. The listed phone number is (618) 419-0011.

What is Backroad Health Care Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Backroad Health Care Inc was last updated on March 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.