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SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA
NPI 1629003074
Clinic/Center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) in Centralia, IL

Active since July 12, 2006
400 N PLEASANT AVE, CENTRALIA, IL 62801(618) 436-8000 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Nov 26, 2019, Jun 19, 2018 (2 updates tracked since 2018).

About Ssm Health St. Mary's Hospital - Centralia NPPES

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

SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA (NPI 1629003074) is a healthcare organization registered as a rehabilitation, comprehensive outpatient rehabilitation facility (corf) in Centralia, Illinois and active in the NPI registry since July 2006. The organization lists Damon R Harbison, President, as its authorized official.

NPPES Registry Identity

NPI1629003074
Entity TypeOrganization
Primary Taxonomy261QR0401X
Legal Business NameST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS
Location Address400 N PLEASANT AVECentralia, IL 62801
Mailing AddressPo Box 503861Saint Louis, MO 63150-0001 · (618) 436-8000
Phone(618) 436-8000
Organization SubpartNo
Authorized OfficialDamon R HarbisonPresident · (618) 436-6205
Enumeration DateJuly 12, 2006
Last NPPES UpdateNovember 27, 20232 updates tracked since enumeration
✔ NPI 1629003074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)Ambulatory Health Care Facilities
Taxonomy Code261QR0401X
License✔ Licensed in IL · 0002642
400 N PLEASANT AVE, Centralia, IL 62801
Open in Google Maps ↗

Other Names 1

Doing Business AsSsm Health St. Mary's Hospital - Centralia

Other Identifiers 1

Other6123830IL · Blue Cross Blue Shield

Other Providers at the Same Location NPPES 20

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

MRS. MELISSA KRISTINE VANGIESEN MS, ATC
Specialist/Technologist (Athletic Trainer)
400 N PLEASANT AVE
CENTRALIA, IL 62801
Marion County (618) 436-8641
DR. KIRITKUMAR R SHETH MD
Anesthesiology
400 N PLEASANT AVE
CENTRALIA, IL 62801
Marion County (618) 436-5461
ROBINSON J OMOTOLA CRNA
Nurse Anesthetist, Certified Registered
400 N PLEASANT AVE
CENTRALIA, IL 62801
Marion County (618) 436-5461
MR. TODD MICHAEL HOYT ATC
Specialist/Technologist (Athletic Trainer)
400 N PLEASANT AVE
CENTRALIA, IL 62801
Marion County (618) 436-8641
KIMBERLY GOING P.T.
Physical Therapist
400 N PLEASANT AVE
CENTRALIA, IL 62801
Marion County (618) 436-8640
BETH FADLER P.T.
Physical Therapist
400 N PLEASANT AVE
CENTRALIA, IL 62801
Marion County (618) 436-8641
LINDA D BRYAN
Speech-Language Pathologist
400 N PLEASANT AVE
CENTRALIA, IL 62801
Marion County (618) 436-8637
MRS. BARBARA DAWN BECKER FNP
Nurse Practitioner (Family)
400 N PLEASANT AVE
CENTRALIA, IL 62801
Marion County (618) 436-6000

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 St. Mary's Hospital, Centralia, Illinois's NPI number?

The NPI number for St. Mary's Hospital, Centralia, Illinois is 1629003074. It was assigned to this organization in the NPPES registry on July 12, 2006.

Where is St. Mary's Hospital, Centralia, Illinois located?

St. Mary's Hospital, Centralia, Illinois is located at 400 N Pleasant Ave, Centralia, IL 62801. The listed phone number is (618) 436-8000.

What is St. Mary's Hospital, Centralia, Illinois's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF), with taxonomy code 261QR0401X.

When was this NPI record last updated?

The NPPES record for St. Mary's Hospital, Centralia, Illinois was last updated on November 27, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.