OrganizationActive
Advanced Surgical Technology, LLC
NPI 1902583909 · Rural Health Clinic/Center · Mount Vernon, IL
Provider details
- NPI number
- 1902583909
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jennia Rensing, Office Manager(618) 899-9200
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
4200 Williamson Pl Ste 1a
Mount Vernon, IL 62864-6705
Phone: (618) 899-9195
Fax: (618) 918-7151
Street-level locationGet directions
Mailing address
4200 Williamson Pl Ste 1a
Mount Vernon, IL 62864-6705
Other names (DBA / former)
- Doing business as
- Ast Primary Care Mt Vernon
Registry dates
- Enumerated
- 2023-06-30
- Last updated
- 2023-06-30
- Certified
- 2023-06-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.