Individual provider Active NPI

Zachary Jason Emmons, DO

  • Pediatrics Physician
  • Springfield, IL
National Provider Identifier
1235669565
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
125070682 Issued in IL
Practice address
800 E Carpenter St
Springfield, IL 62769-1000
Phone
(217) 535-3699
NPI assigned
Jun 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 010069 AZ
Student in an Organized Health Care Education/Training Program 390200000X NM
Pediatrics Physician 208000000X 125070682 IL Primary

Addresses

Primary practice location

800 E Carpenter St
Springfield, IL 62769-1000

Mailing address

400 N 9TH St
Springfield, Il, IL 62702
Phone (217) 544-6464

Other practice location 1

Msc (Pediatrics-Neonatology) 1 University Of New Mexico
Albuquerque, NM 87131-1000
Phone (805) 861-8861

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170808002280 IL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7315218401

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010069AZMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Estrella Medical Center Past Accepting new patients
Hospital Development of West Phoenix Inc Past Accepting new patients
Banner Thunderbird Medical Center Past Accepting new patients
VHS of Arrowhead, Inc Past Accepting new patients
Arizona OB GYN Affiliates PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: zachary.emmons.1@14294.direct.athenahealth.com

Organizations & group practices 5

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": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1235669565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N 9TH ST",
            "city": "SPRINGFIELD, IL",
            "state": "IL",
            "postal_code": "62702",
            "telephone_number": "217-544-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627691000",
            "telephone_number": "217-535-3699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Msc (Pediatrics-Neonatology) 1 University Of New Mexico",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871311000",
            "country_code": "US",
            "telephone_number": "805-861-8861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMMONS",
        "first_name": "ZACHARY",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-19",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "AZ",
            "license": "010069",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125070682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.