NPIMap

Organization Active NPI

Family Medicine in Columbia

  • Family Medicine Physician
  • Columbia, IL
National Provider Identifier
1144320086
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY MEDICINE IN COLUMBIA
Practice address
123 Wedgewood Dr
Columbia, IL 62236
Phone
(618) 281-2233
Fax
(618) 281-2244
NPI assigned
Sep 22, 2006
Last updated
Sep 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Authorized official

Name
Dr. Andrzej J Wasiak, MD
Title
President
Phone
(618) 281-2233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

123 Wedgewood Dr
Columbia, IL 62236

Mailing address

123 Wedgewood Dr
Columbia, IL 62236
Phone (618) 281-2233

National Provider Directory

National Provider Directory

Locations

123 Wedgewood Dr
Columbia, IL 62236
Phone (618) 281-2233

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190678400000",
    "number": "1144320086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 WEDGEWOOD DR",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "62236",
            "telephone_number": "618-281-2233",
            "fax_number": "618-281-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 WEDGEWOOD DR",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "62236",
            "telephone_number": "618-281-2233",
            "fax_number": "618-281-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE IN COLUMBIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-09-25",
        "status": "A",
        "authorized_official_last_name": "WASIAK",
        "authorized_official_first_name": "ANDRZEJ",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-281-2233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.