Southern Illinois Medical Specialists, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036.125672 Issued in IL

Legal business name

SOUTHERN ILLINOIS MEDICAL SPECIALISTS, LLC

Practice address

107 W Franklin St
Sesser, IL 62884-1456

Phone

(618) 625-2105

Fax

(618) 625-2108

NPI assigned

Apr 25, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lee Peter Bee, D.O., F.A.C.O.I.

Title

Ceo/Sole Member/Manager

Phone

(618) 625-2105

Specialties & licenses 11

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366848000000",
    "number": "1013351667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W FRANKLIN ST",
            "city": "SESSER",
            "state": "IL",
            "postal_code": "628841456",
            "telephone_number": "618-625-2105",
            "fax_number": "618-625-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W FRANKLIN ST",
            "city": "SESSER",
            "state": "IL",
            "postal_code": "628841456",
            "telephone_number": "618-625-2105",
            "fax_number": "618-625-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS MEDICAL SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-25",
        "last_updated": "2013-04-25",
        "status": "A",
        "authorized_official_last_name": "BEE",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "CEO/SOLE MEMBER/MANAGER",
        "authorized_official_telephone_number": "618-625-2105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O., F.A.C.O.I."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.125672",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "034.009566",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "4273",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2012021377",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.125672",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "034.009566",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "4273",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2012021377",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "IL",
            "license": "036.125672",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "IL",
            "license": "036.125672",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "036.125672",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036125672",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Toni K Owens, RN
• James J Pavlovich, M.D.
• Jilissa M Payne, RDH
• Jami D Ramsey, RN
• Sesser Valier Cud 196
• Southern Illinois Medical Specialists, LLC
• Jessica Lee Stroud, DMD
• Rachel Lynn Sullivan, RN
• Brandie Nichole Williams, APRN
• Emily Christine Wright, RDH

• All providers in Sesser, IL
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.