Individual provider Active NPI

Mayra A Arzon, MD

  • Pediatrics Physician
  • Decatur, IL
National Provider Identifier
1114958048
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Practice address
One Memorial Dr
Ste 101
Decatur, IL 62526
Phone
(217) 875-0690
Fax
(217) 875-4148
NPI assigned
Jul 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X IL Primary

Addresses

Primary practice location

One Memorial Dr
Ste 101
Decatur, IL 62526

Mailing address

One Memorial Dr
Ste 101
Decatur, IL 62526
Phone (217) 875-0690

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 Medicine

State licenses

LicenseStateTypeSpecialty
036079387ILMDPediatrics Physician

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IAFFCA/Endpoint/IAFFCA

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114958048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE MEMORIAL DR",
            "address_2": "STE 101",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "62526",
            "telephone_number": "217-875-0690",
            "fax_number": "217-875-4148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE MEMORIAL DR",
            "address_2": "STE 101",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "62526",
            "telephone_number": "217-875-0690",
            "fax_number": "217-875-4148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARZON",
        "first_name": "MAYRA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.