Ruth D Mayforth, M.D.

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

036105117 Issued in IL

Practice address

301 N 8TH St
Pav4A
Springfield, IL 62701-1041

Phone

(217) 545-0702

Fax

(217) 545-7305

NPI assigned

Sep 23, 2005

Last updated

Jul 20, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• HSHS Prairie, Inc

  dba HSHS Medical Group Family Medicine - Dieterich

  • Rural Health Clinic/Center
  • Dieterich, IL
  • NPI 1033841192
  NPD (past)

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279584000000",
    "number": "1184610255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19655",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949655",
            "telephone_number": "217-545-0702",
            "fax_number": "217-545-7305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N 8TH ST",
            "address_2": "PAV4A",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011041",
            "telephone_number": "217-545-0702",
            "fax_number": "217-545-7305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYFORTH",
        "first_name": "RUTH",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-23",
        "last_updated": "2010-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "IL",
            "license": "036105117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105117",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Ariel Mayberry, DC
• Alea Denise Maye
• Shawn Andrew Mayer, M.D.
• Stephen A Mayer, M.D.
• Allison Mayfield, M.D.
• Jami Jo Mazurek, PTA
• Kenneth Edward MC Keon, MD
• Cathy Lomelino McAfee, M.D.
• Monica Rose McAfee, COTA/L
• Jayne McAlexander, MA, MSW, LCSW, DMIN

• Pediatric Surgery Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Pediatric Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2010; 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.