Active NPI
Amanda Youmans, D.O.
- Forensic Pathology Physician
- Peoria, IL
National Provider Identifier
1093976169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Pathology Physician
- License
- 036125159
- Practice address
- 506 E Seneca PL
Peoria, IL 61603 - Phone
- (309) 669-2000
- NPI assigned
- Jun 21, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 125052610 | IL | |
| Forensic Pathology Physician | 207ZF0201X | 036125159 | IL | Primary |
Addresses
Primary practice location
506 E Seneca PL
Peoria, IL 61603
Mailing address
PO Box 940
Morris, IL 60450-0940
Phone (815) 416-9208
Other practice location 1
104 W Front St
Bloomington, IL 61701-5005
Phone (309) 888-5210
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036125159 | IL | MD | Forensic Pathology Physician |
| 125052610 | IL | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561939200000",
"number": "1093976169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 940",
"city": "MORRIS",
"state": "IL",
"postal_code": "604500940",
"telephone_number": "815-416-9208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 E SENECA PL",
"city": "PEORIA",
"state": "IL",
"postal_code": "61603",
"telephone_number": "309-669-2000"
}
],
"practiceLocations": [
{
"address_1": "104 W Front St",
"address_purpose": "LOCATION",
"city": "Bloomington",
"state": "IL",
"postal_code": "617015005",
"country_code": "US",
"telephone_number": "309-888-5210",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YOUMANS",
"first_name": "AMANDA",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-21",
"last_updated": "2019-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "IL",
"license": "125052610",
"primary": false
},
{
"code": "207ZF0201X",
"taxonomy_group": "",
"desc": "Pathology, Forensic Pathology",
"state": "IL",
"license": "036125159",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.