Active NPI
Jamie Wallman, MD
- Family Medicine Physician
- Springfield, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036.156581
- Practice address
- 319 E Madison St Ste 1F
Springfield, IL 62701-3118 - Phone
- (217) 545-8000
- NPI assigned
- Aug 3, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 125-044483 | IL | |
| Family Medicine Physician | 207Q00000X | 036.156581 | IL | Primary |
Addresses
Primary practice location
319 E Madison St Ste 1F
Springfield, IL 62701-3118
Mailing address
201 E Madison St Ste 328
Springfield, IL 62702-5131
Phone (217) 545-8000
Other practice location 1
520 N 4th St
Springfield, IL 62702-5238
Phone (217) 545-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Southern Illinois University School of Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
520 N 4TH St
Springfield, IL 62702-5238
Phone (217) 545-8000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.156581 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Board of Trustees of Southern Illinois University | Current | Accepting new patients | |
| Board of Trustees of Southern Illinois University | Family Medicine | Current | Accepting new patients |
| Board of Trustees of Southern Illinois University | Current | Accepting new patients | |
| Board of Trustees of Southern Illinois University | Current | Accepting new patients | |
| Southern Illinois University | Past | Accepting new patients |
Locations
319 E Madison St
Ste 1F
Springfield, IL 62701
Phone (217) 788-3948
520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100
201 E Madison St
Ste 328
Springfield, IL 62702
Networks
- IL HMO C-SNP
- IL PPO Downstate
- devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
- devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
- devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
Interoperability endpoints
- jamiewallman@siusm.allscriptsdirect.net
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Primary Care Clinic/Center
- Springfield, IL
- NPI 1396097960
Family Medicine
-
- Rural Health Clinic/Center
- Carbondale, IL
- NPI 1215978127
-
- Federally Qualified Health Center (FQHC)
- Carbondale, IL
- NPI 1568210425
-
- Primary Care Clinic/Center
- Springfield, IL
- NPI 1922350099
-
- Clinic/Center
- E Saint Louis, IL
- NPI 1306273776
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Springfield, IL
- NPI 1255317590
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675900800000",
"number": "1013495878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 E MADISON ST STE 328",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627025131",
"telephone_number": "217-545-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "319 E MADISON ST STE 1F",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627013118",
"telephone_number": "217-545-8000"
}
],
"practiceLocations": [
{
"address_1": "520 N 4th St",
"address_purpose": "LOCATION",
"city": "Springfield",
"state": "IL",
"postal_code": "627025238",
"country_code": "US",
"telephone_number": "217-545-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALLMAN",
"first_name": "JAMIE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-03",
"last_updated": "2023-02-09",
"certification_date": "2023-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "125-044483",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036.156581",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.