Individual provider Active NPI

Bill Bates Daily Jr., M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Swansea, IL
National Provider Identifier
1275539140
Registry record updated Aug 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
036092758 Issued in IL
Practice address
9 Park PL
Swansea, IL 62226-2967
Phone
(618) 233-5722
Fax
(618) 233-7069
NPI assigned
Jun 24, 2005
Last updated
Aug 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 036092758 IL Primary

Addresses

Primary practice location

9 Park PL
Swansea, IL 62226-2967

Mailing address

9 Park PL
Swansea, IL 62226-2967
Phone (618) 233-5722

Other identifiers 4

IdentifierTypeStateIssuer
R4P78OtherMOLICENSE
102595OtherMOBNDD
036054159OtherILSUBSTANCE CONTROL
036092758OtherILLICENSE

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
036092758ILMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Management Inc Past Accepting new patients
Memorial Management Inc Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344211200000",
    "number": "1275539140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 PARK PL",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262967",
            "telephone_number": "618-233-5722",
            "fax_number": "618-233-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 PARK PL",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262967",
            "telephone_number": "618-233-5722",
            "fax_number": "618-233-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAILY",
        "first_name": "BILL",
        "middle_name": "BATES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2012-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": "036092758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "R4P78",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BNDD",
            "identifier": "102595",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUBSTANCE CONTROL",
            "identifier": "036054159",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "036092758",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "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 Aug 6, 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.