OrganizationActive
Backroad Health Care Inc
NPI 1134582018 · Family Nurse Practitioner · Centralia, IL
Provider details
- NPI number
- 1134582018
- Entity type
- Organization
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Paul Havrilka, Fnp/Owner(618) 419-0011
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(77/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
211 S Perrine Ave
Centralia, IL 62801-3635
Phone: (618) 419-0011
Fax: (888) 980-2931
Street-level locationGet directions
Mailing address
314 S Poplar St Unit 864
Centralia, IL 62801-0848
Additional practice locations (1)
- 7825a E Grant RdWalnut Hill, IL 62893-1613Phone: (618) 545-0707Fax: (888) 802-1633
Registry dates
- Enumerated
- 2016-03-30
- Last updated
- 2019-03-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.