NPIMap

Organization Active NPI

DM Physicians of Belleville Il, LLC

  • Specialist
  • Belleville, IL
National Provider Identifier
1073564878
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
DM PHYSICIANS OF BELLEVILLE IL, LLC
Practice address
211 S 3Rd St
Belleville, IL 62220-1915
Phone
(618) 234-2120
NPI assigned
May 15, 2006
Last updated
Oct 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Authorized official

Name
Richard A Snow
Title
Managing Partner
Phone
(336) 884-1830

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

211 S 3Rd St
Belleville, IL 62220-1915

Mailing address

PO Box 16068
High Point, NC 27261-6068
Phone (336) 882-4615

Other identifiers 1

IdentifierTypeStateIssuer
742065OtherHEALTHLINK PIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1073564878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16068",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272616068",
            "telephone_number": "336-882-4615",
            "fax_number": "336-884-1643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S 3RD ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201915",
            "telephone_number": "618-234-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DM PHYSICIANS OF BELLEVILLE IL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "SNOW",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "336-884-1830"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PIN",
            "identifier": "742065",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.