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MODERT FAMILY PRACTICE, LTD.
NPI 1255311700
Family Medicine in Mount Vernon, IL

Active since January 19, 2006CLIA 14D0705560 · Microscopy
1 DOCTORS PARK RD STE C, MOUNT VERNON, IL 62864(618) 244-1234 Get Directions Write a Review

NPPES record last updated: November 4, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 4, 2020, May 16, 2018, May 12, 2018 (3 updates tracked since 2018).

About Modert Family Practice, Ltd. NPPES

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

MODERT FAMILY PRACTICE, LTD. (NPI 1255311700) is a healthcare organization registered as a family medicine in Mount Vernon, Illinois and active in the NPI registry since January 2006. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists Sara K. Modert, President, as its authorized official.

NPPES Registry Identity

NPI1255311700
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMODERT FAMILY PRACTICE, LTD.
Location Address1 DOCTORS PARK RD STE CMount Vernon, IL 62864-6251
Mailing AddressPo Box 802Mount Vernon, IL 62864-0017 · (618) 244-1234
Phone(618) 244-1234
Organization SubpartNo
Authorized OfficialSara K. ModertPresident · (618) 244-1234
Enumeration DateJanuary 19, 2006
Last NPPES UpdateNovember 4, 20203 updates tracked since enumeration
NPPES CertifiedNovember 4, 2020
✔ NPI 1255311700 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.
1 DOCTORS PARK RD STE C, Mount Vernon, IL 62864
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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 for Provider-Performed Microscopy Procedures (PPMP) 14D0705560

Modert Family Practice · Mount Vernon, IL
Active · expires Aug 31, 2026
CLIA Number14D0705560
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorChristopher W. Modert Do
Laboratory Phone(618) 244-1234
Laboratory LocationModert Family Practice#1 Doctor's Park Road - Suite C, Mount Vernon, IL 62864
CLIA data matches this NPI record on: Name 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.

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.

CHRISTOPHER WILSON MODERT D.O.
Family Medicine
1 DOCTORS PARK RD STE C
MOUNT VERNON, IL 62864
Jefferson County (618) 244-1234
DR. SARA KNEEDLER MODERT D.O.
Family Medicine
1 DOCTORS PARK RD STE C
MOUNT VERNON, IL 62864
Jefferson County (618) 244-1234

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 Modert Family Practice, Ltd.'s NPI number?

The NPI number for Modert Family Practice, Ltd. is 1255311700. It was assigned to this organization in the NPPES registry on January 19, 2006.

Where is Modert Family Practice, Ltd. located?

Modert Family Practice, Ltd. is located at 1 Doctors Park Rd Ste C, Mount Vernon, IL 62864. The listed phone number is (618) 244-1234.

What is Modert Family Practice, Ltd.'s specialty?

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

Does Modert Family Practice, Ltd. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 14D0705560) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Modert Family Practice, Ltd. was last updated on November 4, 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.