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MARISSA MEDICAL CLINIC
NPI 1922114800
Clinic/Center - Rural Health in Marissa, IL

Active since August 22, 2006CLIA 14D1005513 · Microscopy
521 N BORDERS AVE STE C, MARISSA, IL 62257(618) 295-1591(618) 295-1473 Get Directions Write a Review

NPPES record last updated: May 16, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: May 16, 2023, Aug 21, 2018, Jun 8, 2017 (3 updates tracked since 2017).

About Marissa Medical Clinic NPPES

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

MARISSA MEDICAL CLINIC (NPI 1922114800) is a healthcare organization registered as a rural health in Marissa, Illinois and active in the NPI registry since August 2006. The organization holds a CLIA Microscopy certificate valid through April 23, 2028 and lists Lisa Ernsting, Cfo, as its authorized official.

NPPES Registry Identity

NPI1922114800
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameSPARTA COMMUNITY HOSPITAL D/B/A QUALITY HEALTHCARE CLINICS
Location Address521 N BORDERS AVE STE CMarissa, IL 62257-1195
Mailing AddressPo Box 297Sparta, IL 62286-0297 · (618) 443-1337 · Fax (618) 443-1383
Phone(618) 295-1591
Fax(618) 295-1473
Organization SubpartNo
Authorized OfficialLisa ErnstingCfo · (618) 433-2177
Enumeration DateAugust 22, 2006
Last NPPES UpdateMay 16, 20233 updates tracked since enumeration
NPPES CertifiedMay 16, 2023
✔ NPI 1922114800 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
521 N BORDERS AVE STE C, Marissa, IL 62257
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Other Names 1

Other NameMarissa Medical Clinic

Other Identifiers 1

Other143490IL · Rhc Provider Number Oscar

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) 14D1005513

Marissa Medical Clinic · Marissa, IL
Active · expires Apr 23, 2028
CLIA Number14D1005513
Laboratory TypePhysician Office
Certificate Effective DateApril 24, 2026
Certificate Expiration DateApril 23, 2028
Laboratory DirectorKelly Wood MD
Laboratory Phone(618) 295-1591
Laboratory LocationMarissa Medical Clinic521 C North Borders, Marissa, IL 62257
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.

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 Sparta Community Hospital D/B/A Quality Healthcare Clinics's NPI number?

The NPI number for Sparta Community Hospital D/B/A Quality Healthcare Clinics is 1922114800. It was assigned to this organization in the NPPES registry on August 22, 2006. The provider is also known as Marissa Medical Clinic.

Where is Sparta Community Hospital D/B/A Quality Healthcare Clinics located?

Sparta Community Hospital D/B/A Quality Healthcare Clinics is located at 521 N Borders Ave Ste C, Marissa, IL 62257. The listed phone number is (618) 295-1591.

What is Sparta Community Hospital D/B/A Quality Healthcare Clinics's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Sparta Community Hospital D/B/A Quality Healthcare Clinics hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 14D1005513) is associated with this NPI, valid through April 23, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Sparta Community Hospital D/B/A Quality Healthcare Clinics was last updated on May 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.