Active NPI
Adult Internal Medicine Practice LLC
- Internal Medicine Physician
- Swansea, IL
National Provider Identifier
1265688238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- ADULT INTERNAL MEDICINE PRACTICE LLC
- Practice address
- 15 Park PL
Swansea, IL 62226-2918 - Phone
- (618) 257-0780
- Fax
- (618) 257-0715
- NPI assigned
- Aug 11, 2008
- Last updated
- Sep 6, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Charles W Ampadu, M.D.
- Title
- Owner
- Phone
- (618) 257-0780
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | NU | Primary |
Addresses
Primary practice location
15 Park PL
Swansea, IL 62226-2918
Mailing address
15 Park PL
Swansea, IL 62226-2918
Phone (618) 257-0780
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32871 | Other | GHP | |
| 08227444 | Other | IL | BCBS |
| 036083270 | Medicaid | IL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dr.ampadufacp@ampadumed.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, MO
Enrollment records 2
National Provider Directory
National Provider DirectoryLocations
15 Park Pl
Ste 101
Swansea, IL 62226
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218412800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1630886400000",
"number": "1265688238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 PARK PL",
"city": "SWANSEA",
"state": "IL",
"postal_code": "622262918",
"telephone_number": "618-257-0780",
"fax_number": "618-355-9972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 PARK PL",
"city": "SWANSEA",
"state": "IL",
"postal_code": "622262918",
"telephone_number": "618-257-0780",
"fax_number": "618-257-0715"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADULT INTERNAL MEDICINE PRACTICE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-08-11",
"last_updated": "2021-09-06",
"certification_date": "2021-09-06",
"status": "A",
"authorized_official_last_name": "AMPADU",
"authorized_official_first_name": "CHARLES",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "618-257-0780",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHP",
"identifier": "32871",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "08227444",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036083270",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dr.ampadufacp@ampadumed.com",
"affiliation": "N",
"endpointDescription": "secure email address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "secure email address",
"address_1": "15 Park Pl",
"city": "Swansea",
"state": "IL",
"country_code": "US",
"postal_code": "622262918",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Swansea, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.