Uretz John Oliphant, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036072317 Issued in IL

Practice address

200 Lerna Rd S
Mattoon, IL 61938-9388

Phone

(217) 258-5900

NPI assigned

Jun 20, 2006

Last updated

Mar 30, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Carle Eureka Hospital

  dba Carle Eureka Family Medicine - Roanoke

  • Rural Health Clinic/Center
  • Roanoke, IL
  • NPI 1568061059

  Corporate Director

  CMS ownership
• The Carle Foundation Hospital

  dba Carle Hospice

  • Community Based Hospice Care Agency
  • Champaign, IL
  • NPI 1851387385

  Corporate Director

  CMS ownership
• The Carle Foundation Hospital

  dba Carle Home Care

  • Home Health Agency
  • Champaign, IL
  • NPI 1891780615

  Corporate Director

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carle Health Medical Group

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment NPD
• Carle West Physician Group Inc

  • Family Medicine Physician
  • Normal, IL
  • NPI 1467074138
  Medicare reassignment NPD
• Richland Memorial Hospital, Inc

  dba Carle Richland Memorial Hospital

  • Critical Access Hospital
  • Olney, IL
  • NPI 1467492124
  Medicare reassignment NPD
• Richland Memorial Hospital, Inc

  • Otolaryngology Physician
  • Olney, IL
  • NPI 1700063179

  Surgery

  NPD
• Carle Health Care Incorporated

  • Durable Medical Equipment & Medical Supplies
  • Champaign, IL
  • NPI 1114240876
  NPD (past)
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1033154109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LERNA RD S",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619389388",
            "telephone_number": "217-258-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Franklin Ave",
            "address_purpose": "LOCATION",
            "city": "Normal",
            "state": "IL",
            "postal_code": "617613592",
            "country_code": "US",
            "telephone_number": "309-268-3900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3105 Fields South Dr",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618223743",
            "country_code": "US",
            "telephone_number": "217-902-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIPHANT",
        "first_name": "URETZ",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036072317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CLINIC PTAN",
            "identifier": "754210",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC GROUP NPI",
            "identifier": "1255380846",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036072317",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1033154109",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana L. Oakley, APN
• Jennifer Ogle, MSW
• Terra Lynn Ogle, LCSW
• Kim Ohl, NP
• Dionne C Okafor
• Omnicare Labs of Champaign Inc (Omni Prosthetics and Orthotics)
• Oneopto Il 2 PLLC (All About Eyes)
• Olanrewaju Oni, MD
• Ijeoma F. Onyeyirim, CRNA
• Open MRI of Coles County LLC

• Surgery Physician in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.