NPIMap

Organization Active NPI

Preston Scott Medical Group

  • Family Medicine Physician
  • Belvidere, IL
National Provider Identifier
1033380514
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036110520 Issued in IL
Legal business name
PRESTON SCOTT MEDICAL GROUP
Practice address
1906 Pierce CT
Belvidere, IL 61008-1742
Phone
(815) 547-9737
Fax
(815) 547-9740
NPI assigned
Mar 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Authorized official

Name
Randall Robyn, MD
Title
Owner
Phone
(815) 547-9737

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 036110520 IL Primary

Addresses

Primary practice location

1906 Pierce CT
Belvidere, IL 61008-1742

Mailing address

1906 Pierce CT
Belvidere, IL 61008-1742
Phone (815) 547-9737

National Provider Directory

National Provider Directory

Locations

1906 Pierce Ct
Belvidere, IL 61008
Phone (815) 547-9737

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1033380514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 PIERCE CT",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610081742",
            "telephone_number": "815-547-9737",
            "fax_number": "815-547-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 PIERCE CT",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610081742",
            "telephone_number": "815-547-9737",
            "fax_number": "815-547-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTON SCOTT MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "ROBYN",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-547-9737",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036110520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belvidere, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.