Individual provider Active NPI

Kendall C Newsome, MD

  • Diagnostic Ultrasound Physician
  • Urbana, IL
National Provider Identifier
1083721435
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X
License
036101939 Issued in IL
Practice address
611 W. Park St.
Radiology
Urbana, IL 61801
Phone
(217) 383-3270
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Ultrasound Physician 2085U0001X 036101939 IL Primary

Addresses

Primary practice location

611 W. Park St.
Radiology
Urbana, IL 61801

Mailing address

611 W. Park St.
BWPC
Urbana, IL 61801-2500
Phone (217) 383-6792

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090924000302 IL Practitioner - Diagnostic Radiology 9133275688 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated CurrentSince Apr 1, 2010 Accepting new patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Apr 1, 2020 Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Mar 25, 2014 Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Mar 25, 2014 Accepting new patients
Richland Memorial Hospital, Inc Current Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Apr 1, 2020 Accepting new patients
Carle West Physician Group Inc CurrentSince Mar 17, 2022 Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

837 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5530

1000 Medical Center Dr
Monticello, IL 61856
Phone (217) 762-1540

900 E Scott St
Olney, IL 62450
Phone (618) 345-1000

1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194

810 W Anthony Dr
Urbana, IL 61802
Phone (217) 326-2911

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: knewsomemd75301@carlehiedirect.net

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1083721435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-6792",
            "fax_number": "217-383-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "RADIOLOGY",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801",
            "telephone_number": "217-383-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWSOME",
        "first_name": "KENDALL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "IL",
            "license": "036101939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.