Active NPI
Pamela J. Rundle, M.D.
- Obstetrics & Gynecology Physician
- Springfield, IL
National Provider Identifier
1144313008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 036-105965
- Practice address
- 900 N. 1St Street
Springfield, IL 62702-3749 - Phone
- (217) 528-7541
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 036-105965 | IL | Primary |
Addresses
Primary practice location
900 N. 1St Street
Springfield, IL 62702-3749
Mailing address
1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036105965 | Medicaid | IL |
Other names 1
- Pamela J. McGilvray
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 |
|---|---|---|---|
| 036-105965 | IL | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Springfield Clinic LLP | Current | Accepting new patients |
Locations
300 N Broad St
Carlinville, IL 62626
Phone (217) 544-2020
1025 S 6th St
Springfield, IL 62703
Interoperability endpoints
- pamelarundle@sfc.allscriptsdirect.net
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Springfield, IL
- NPI 1215974415
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589932800000",
"number": "1144313008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 S 6TH ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627032403",
"telephone_number": "217-528-7541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 N. 1ST STREET",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627023749",
"telephone_number": "217-528-7541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUNDLE",
"first_name": "PAMELA",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2020-05-20",
"certification_date": "2020-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IL",
"license": "036-105965",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036105965",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "PAMELA",
"last_name": "MCGILVRAY",
"middle_name": "J.",
"code": "1",
"type": "Former Name"
}
]
}
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 May 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.