Decatur Pediatric Clinic

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

DECATUR PEDIATRIC CLINIC

Practice address

1770 E Lake Shore Dr
Decatur, IL 62521-3832

Phone

(217) 423-8800

Fax

(217) 422-8120

NPI assigned

Dec 29, 2006

Organization subpart

No

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

Authorized official

Name

Jamie S Warnick, MD

Title

Owner

Phone

(217) 423-8800

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184780348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 E LAKE SHORE DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213832",
            "telephone_number": "217-423-8800",
            "fax_number": "217-422-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 E LAKE SHORE DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213832",
            "telephone_number": "217-423-8800",
            "fax_number": "217-422-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR PEDIATRIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WARNICK",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-423-8800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Decatur Memorial Hospital
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• Decatur OBGYN Associates, LLC
• Decatur Open MRI, Inc.
• Decatur Pharmacyxpress LLC
• Decatur Psychiatry LTD
• Decatur Psychological Associates PC
• Decatur Public School Dist. #61
• Decatur Radiology Physicians Services PLLC

• Pediatrics Physician in Decatur, IL
• Providers in Decatur, IL by specialty
• Pediatrics Physician in Illinois

• 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.