Individual provider Active NPI

Richard E Katholi, M.D.

  • Cardiovascular Disease Physician
  • Springfield, IL
National Provider Identifier
1245312529
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036073624 Issued in IL
Practice address
619 E Mason St
Suite 4P57
Springfield, IL 62701-1034
Phone
(217) 788-0706
Fax
(217) 525-2535
NPI assigned
Oct 19, 2006
Last updated
Dec 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036-073624 IL
Cardiovascular Disease Physician 207RC0000X 036073624 IL Primary

Addresses

Primary practice location

619 E Mason St
Suite 4P57
Springfield, IL 62701-1034

Mailing address

PO Box 19420
Springfield, IL 62794-9420
Phone (217) 788-0706

Other identifiers 2

IdentifierTypeStateIssuer
036073624MedicaidIL
080009979OtherILRAILROAD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rkatholi100005@ewd.direct.hshs.org Direct

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
I20051005000234 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Other (Physician) 1355376658 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-073624ILMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
McDonough County Hospital District Current Accepting new patients
Schuyler County Hospital District CurrentSince Jan 1, 2000 Accepting new patients
Schuyler County Hospital District CurrentSince Jan 1, 2000 Accepting new patients
McDonough County Hospital District CurrentSince Feb 4, 2017 Accepting new patients
St Anthonys Memorial Hospital of the Hospital Sisters of the Third CurrentSince Apr 1, 2001 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Sep 12, 2005 Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District CurrentSince Feb 4, 2017 Accepting new patients
Prairie Cardiovascular Consultants LTD Specialist CurrentSince Apr 16, 2013 Accepting new patients
McDonough County Hospital District Current Accepting new patients
Sarah Bush Lincoln Health Center Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince Sep 12, 2005 Accepting new patients
McDonough County Hospital District Current Accepting new patients
Pana Community Hospital Association Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
HSHS Medical Group Inc Past Accepting new patients

Locations

503 N Maple St
Effingham, IL 62401
Phone (217) 342-2121

1215 Franciscan Dr
Litchfield, IL 62056
Phone (217) 324-2191

525 E Grant St
Macomb, IL 61455
Phone (309) 836-1611

101 E 9th St
Pana, IL 62557
Phone (217) 562-2131

238 S Congress St
Rushville, IL 62681
Phone (217) 322-4321

3051 Hollis Dr
Springfield, IL 62704
Phone (217) 523-5406

619 E Mason St
Ste 4P57
Springfield, IL 62701

800 E Carpenter St
Springfield, IL 62769
Phone (217) 525-5643

800 E Carpenter St
Springfield, IL 62702
Phone (217) 525-5643

650 W Taylor St
Vandalia, IL 62471
Phone (618) 283-1231

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9c9d3cdf-0f7f-4b63-979a-f711747b3e95/
  • Direct secure messaging: rkatholi100005@ewd.direct.hshs.org

Organizations & group practices 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1245312529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19420",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949420",
            "telephone_number": "217-788-0706",
            "fax_number": "217-525-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 E MASON ST",
            "address_2": "SUITE 4P57",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011034",
            "telephone_number": "217-788-0706",
            "fax_number": "217-525-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATHOLI",
        "first_name": "RICHARD",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-073624",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036073624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036073624",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "080009979",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkatholi100005@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "619 E Mason St",
            "address_2": "Suite 4P57",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627011034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.