NPIMap

Individual provider Active NPI

Richard Pearson, MD

  • Surgery Physician
  • Urbana, IL
National Provider Identifier
1225001811
Registry record updated Sep 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036051386 Issued in IL
Practice address
602 West University Avenue
Urbana, IL 61801
Phone
(217) 383-3311
NPI assigned
Feb 13, 2006
Last updated
Sep 3, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MOR5G20 MO
Surgery Physician 208600000X 036051386 IL Primary

Addresses

Primary practice location

602 West University Avenue
Urbana, IL 61801

Mailing address

P.O. Box 6002
Urbana, IL 61803-6002
Phone (217) 383-3311

Other identifiers 17

IdentifierTypeStateIssuer
09-00307OtherMOUHC
102528833MedicaidPA
1592722OtherGATEWAY-WMG
179373OtherMOHEALTHLINK
1123050001OtherMOCIGNA MEDICARE
30084779OtherPAAMERIHEALTH MERCY-WMG
202362927MedicaidMO
416251OtherPAUPMC-WMG
2532177OtherPAHIGHMARK BLUE SHIELD-WMG
35915OtherMOHEALTHCARE USA
I603OtherMOPRINCIPAL
393227OtherPAUNISON-WMG
200025012OtherMORAILROAD MEDICARE
0533210001OtherILDMERC
35270OtherMOBCBS
2831OtherMOGHP
037225100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MOR5G20MOMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ste. Genevieve County Memorial Hospital PastSince Jan 1, 1990 Accepting new patients
Ste Genevieve County Memorial Hospital PastSince Jan 1, 1990 Accepting new patients
Ste Genevieve County Memorial Hospital PastSince Jan 1, 1990 Accepting new patients
Fairbanks Memorial Physician Specialities Past Accepting new patients
Ste Genevieve County Memorial Hospital PastSince Jan 1, 1990 Accepting new patients
Ste Genevieve County Memorial Hospital Orthopaedic Surgery PastSince Jan 1, 1990 Accepting new patients
Ste Genevieve County Memorial Hospital PastSince Jan 1, 1990 Accepting new patients
Ste Genevieve County Memorial Hospital SG MH Pharmacy PastSince Jan 1, 1990 Accepting new patients
Ste Genevieve County Memorial Hospital PastSince Jan 1, 1990 Accepting new patients
Inderjit Singh MD Facp LLC Past Accepting new patients
Ste Genevieve County Memorial Hospital PastSince Jan 1, 1990 Accepting new patients
Ste Genevieve County Memorial Hospital PastSince Jan 1, 1990 Accepting new patients
Ste Genevieve County Memorial Hospital PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346630400000",
    "number": "1225001811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 6002",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618036002",
            "telephone_number": "217-383-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 WEST UNIVERSITY AVENUE",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801",
            "telephone_number": "217-383-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2012-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "MOR5G20",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036051386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "09-00307",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102528833",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY-WMG",
            "identifier": "1592722",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "179373",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE",
            "identifier": "1123050001",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY-WMG",
            "identifier": "30084779",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202362927",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC-WMG",
            "identifier": "416251",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD-WMG",
            "identifier": "2532177",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA",
            "identifier": "35915",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRINCIPAL",
            "identifier": "I603",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON-WMG",
            "identifier": "393227",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "200025012",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0533210001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "35270",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "2831",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037225100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2012; 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.