Individual provider Active NPI

Craig A Backs, M.D.

  • Internal Medicine Physician
  • Springfield, IL
National Provider Identifier
1124043252
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036065128 Issued in IL
Practice address
2921 Greenbriar Dr
Springfield, IL 62704-6421
Phone
(217) 321-1987
Fax
(866) 594-7830
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036065128 IL Primary

Addresses

Primary practice location

2921 Greenbriar Dr
Springfield, IL 62704-6421

Mailing address

2921 Greenbriar Dr
Springfield, IL 62704-6421
Phone (217) 321-1987

Other identifiers 11

IdentifierTypeStateIssuer
008546OtherILHEALTH ALLIANCE
020057300OtherILBLACK LUNG
100364OtherILHEALTHLINK
6394POtherILCATERPILLAR
036065128MedicaidIL
110201127OtherILRR MEDICARE PIN
133586700OtherILACS-OWCP
08421024OtherILBLUE CROSS BLUE SHIELD
14D0949277OtherILCLIA CERT
CD7143OtherILRR MEDICARE GRP
170765OtherILPERSONAL CARE

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
I20040909000634 IL Practitioner - Internal Medicine 0941276026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Southern Illinois University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2131 W White Oaks Dr
Suite a
Springfield, IL 62704-7416
Phone (217) 321-1987

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036065128ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Craig a Backs MD LLC Internal Medicine CurrentSince Apr 1, 2011 Accepting new patients
Physicians Group Associates S C Internal Medicine Past Accepting new patients
Physicians Group Associates S C Past Accepting new patients
Physicians Group Associates S C Internal Medicine Past Accepting new patients

Locations

2131 W White Oaks Dr
Ste A
Springfield, IL 62704
Phone (217) 321-1987

Organizations & group practices 4

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1124043252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 GREENBRIAR DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046421",
            "telephone_number": "217-321-1987",
            "fax_number": "866-594-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 GREENBRIAR DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046421",
            "telephone_number": "217-321-1987",
            "fax_number": "866-594-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKS",
        "first_name": "CRAIG",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036065128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "008546",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "020057300",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "100364",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CATERPILLAR",
            "identifier": "6394P",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036065128",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "110201127",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS-OWCP",
            "identifier": "133586700",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "08421024",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA CERT",
            "identifier": "14D0949277",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GRP",
            "identifier": "CD7143",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CARE",
            "identifier": "170765",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.