Active NPI
Stuart Farris, MD
- Ophthalmology Physician
- Springfield, IL
National Provider Identifier
1144279498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- K2462
- Practice address
- 2020 W Iles Ave
Springfield, IL 62704-4174 - Phone
- (217) 698-3030
- Fax
- (217) 698-3068
- NPI assigned
- May 6, 2006
- Last updated
- Mar 15, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | K2462 | TX | Primary |
Addresses
Primary practice location
2020 W Iles Ave
Springfield, IL 62704-4174
Mailing address
2020 W Iles Ave
Springfield, IL 62704-4174
Phone (217) 698-3030
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036099170 | Medicaid | IL | |
| 180037213 | Other | IL | RAILROAD MEDICARE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K2462 | TX | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458000000000",
"number": "1144279498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2020 W ILES AVE",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627044174",
"telephone_number": "217-698-3030",
"fax_number": "217-698-3068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 W ILES AVE",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627044174",
"telephone_number": "217-698-3030",
"fax_number": "217-698-3068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARRIS",
"first_name": "STUART",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-06",
"last_updated": "2016-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "TX",
"license": "K2462",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036099170",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180037213",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.