Individual provider Active NPI

Meghan Elizabeth Baumann, PA-C

  • Medical Physician Assistant
  • Decatur, IL
National Provider Identifier
1164479234
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085-002182 Issued in IL
Practice address
355 E Ash Ave
Decatur, IL 62526-6136
Phone
(217) 450-9826
Fax
(217) 717-2346
NPI assigned
May 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085-002182 IL Primary

Addresses

Primary practice location

355 E Ash Ave
Decatur, IL 62526-6136

Mailing address

355 E Ash Ave
Decatur, IL 62526-6136
Phone (217) 450-9826

Other practice location 1

917 Remington Rd
Mattoon, IL 61938-4210
Phone (217) 205-3376

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110418000811 IL Practitioner - Physician Assistant 3678757549 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-002182ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalskin Medical Group Il PLLC CurrentSince Jan 29, 2021 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

355 E Ash Ave
Decatur, IL 62526
Phone (217) 450-9826

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

917 Remington Rd
Mattoon, IL 61938
Phone (217) 205-3376

1111 W Kenyon Rd
Urbana, IL 61801
Phone (217) 729-7650

Organizations & group practices 3

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1164479234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 E ASH AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625266136",
            "telephone_number": "217-450-9826",
            "fax_number": "217-717-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 E ASH AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625266136",
            "telephone_number": "217-450-9826",
            "fax_number": "217-717-2346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "917 Remington Rd",
            "address_purpose": "LOCATION",
            "city": "Mattoon",
            "state": "IL",
            "postal_code": "619384210",
            "country_code": "US",
            "telephone_number": "217-205-3376",
            "fax_number": "217-481-7020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUMANN",
        "first_name": "MEGHAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085-002182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.