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SSM HEALTH ST. MARY'S HOSPITAL - CENTRALIA
NPI 1710105192
Clinic/Center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) in Centralia, IL

Active since April 23, 2007
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 26, 2026.

Record update history: Nov 26, 2019, Jun 20, 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 1710105192) is a healthcare organization registered as a rehabilitation, comprehensive outpatient rehabilitation facility (corf) in Centralia, Illinois and active in the NPI registry since April 2007. The organization lists Damon R Harbison, President, as its authorized official.

NPPES Registry Identity

NPI1710105192
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 DateApril 23, 2007
Last NPPES UpdateNovember 27, 20232 updates tracked since enumeration
✔ NPI 1710105192 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.

HONG CHEN MD
Pathology (Anatomic Pathology & Clinical Pathology)
400 N PLEASANT AVE
CENTRALIA, IL 62801
Marion County (618) 436-5034
ST MARY'S HOSPITAL, CENTRALIA, ILLINOIS
General Acute Care Hospital
400 N PLEASANT AVE
CENTRALIA, IL 62801
Marion County (618) 436-8000
BETH FADLER P.T.
Physical Therapist
400 N PLEASANT AVE
CENTRALIA, IL 62801
Marion County (618) 436-8641
MEDS INPATIENT SERVICES ASSOCIATES, INC
Hospitalist
400 N PLEASANT AVE
CENTRALIA, IL 62801
Marion County (618) 436-8000
VIRGINIA YVONNE WAGNER
Social Worker (Clinical)
400 N PLEASANT AVE
CENTRALIA, IL 62801
Marion County (618) 437-8692
MR. TODD MICHAEL HOYT ATC
Specialist/Technologist (Athletic Trainer)
400 N PLEASANT AVE
CENTRALIA, IL 62801
Marion County (618) 436-8641
ST. MARY'S HOSPITAL, CENTRALIA, ILLINOIS
Psychiatric Unit
400 N PLEASANT AVE
CENTRALIA, IL 62801
Marion County (618) 436-8000
CENTRALIA ANESTHESIOLOGY SERVICES LTD
Nurse Anesthetist, Certified Registered
400 N PLEASANT AVE
CENTRALIA, IL 62801
Marion County (618) 436-5521

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 1710105192. It was assigned to this organization in the NPPES registry on April 23, 2007. The provider is doing business as Ssm Health St. Mary's Hospital - Centralia.

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.