Active NPI
Benjamin P Davis, MD
- Emergency Medicine Physician
- Urbana, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 036115760
- Practice address
- 611 W. Park Street
Emergency Medicine
Urbana, IL 61801 - Phone
- (217) 383-4930
- Fax
- (217) 383-4014
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 036115760 | IL | Primary |
Addresses
Primary practice location
611 W. Park Street
Emergency Medicine
Urbana, IL 61801
Mailing address
P.O. Box 6002
Urbana, IL 61803-6002
Phone (217) 326-8300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036-115760 | Medicaid | IL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of Chicago, Pritzker School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
611 W Park St
Urbana, IL 61801-2500
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
Hospital & facility affiliations
- Carle Foundation Hospital
- Kirby Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036115760 | IL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kirby Medical Center | Current | Accepting new patients | |
| Richland Memorial Hospital, Inc. | Current | Accepting new patients | |
| Carle Health Care Incorporated | Emergency Medicine | Current | Accepting new patients |
| Richland Memorial Hospital, Inc | Current | Accepting new patients | |
| Richland Memorial Hospital, Inc | Current | Accepting new patients |
Locations
837 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5530
1000 Medical Center Dr
Monticello, IL 61856
Phone (217) 762-1540
900 E Scott St
Olney, IL 62450
Phone (618) 345-1000
800 E Locust St
Olney, IL 62450
Phone (618) 395-2131
1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Interoperability endpoints
- bdavismd20997@carlehiedirect.net
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
Emergency Medicine
-
- Critical Access Hospital
- Olney, IL
- NPI 1467492124
-
- Critical Access Hospital
- Monticello, IL
- NPI 1730179847
-
- Land Ambulance
- Monticello, IL
- NPI 1598869133
-
- Otolaryngology Physician
- Olney, IL
- NPI 1700063179
-
- Rural Health Clinic/Center
- West Salem, IL
- NPI 1922475037
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Monticello, IL
- NPI 1730179847
-
- General Acute Care Hospital
- Urbana, IL
- NPI 1013071653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338854400000",
"number": "1295760338",
"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": "217-326-8300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 W. PARK STREET",
"address_2": "EMERGENCY MEDICINE",
"city": "URBANA",
"state": "IL",
"postal_code": "61801",
"telephone_number": "217-383-4930",
"fax_number": "217-383-4014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "BENJAMIN",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2012-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036115760",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036-115760",
"state": "IL"
}
],
"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 Jun 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.