NPIMap

Organization Active NPI

Sports Medicine Clinic of Macon County

Doing business as Hills' Sports Medicine & Physical Therapy

  • Physical Therapist
  • Decatur, IL
National Provider Identifier
1174594717
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SPORTS MEDICINE CLINIC OF MACON COUNTY
Doing business as
Hills' Sports Medicine & Physical Therapy
Practice address
1900 E Lake Shore Dr
Suite 150
Decatur, IL 62521-3824
Phone
(217) 428-6222
Fax
(217) 428-2617
NPI assigned
Jan 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Miss Robert W Hill, ATC
Title
Owner, Ceo
Phone
(217) 428-6222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1900 E Lake Shore Dr
Suite 150
Decatur, IL 62521-3824

Mailing address

1900 E Lake Shore Dr
Suite 150
Decatur, IL 62521-3824
Phone (217) 428-6222

Other identifiers 1

IdentifierTypeStateIssuer
5815203OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • Hills' Sports Medicine & Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

1900 E Lake Shore Dr
Ste 150
Decatur, IL 62521
Phone (217) 428-6222

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174594717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 E LAKE SHORE DR",
            "address_2": "SUITE 150",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213824",
            "telephone_number": "217-428-6222",
            "fax_number": "217-428-2617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 E LAKE SHORE DR",
            "address_2": "SUITE 150",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213824",
            "telephone_number": "217-428-6222",
            "fax_number": "217-428-2617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE CLINIC OF MACON COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER, CEO",
        "authorized_official_telephone_number": "217-428-6222",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5815203",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hills' Sports Medicine & Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.