Individual provider Active NPI

Julie Marie Preston, PA-C

  • Medical Physician Assistant
  • Decatur, IL
National Provider Identifier
1306026224
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
385000284 Issued in IL
Practice address
1 Memorial Dr
Physcians Plaza East Ste 110
Decatur, IL 62526-6303
Phone
(217) 422-2442
Fax
(217) 424-9431
NPI assigned
Nov 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 385000284 IL Primary

Addresses

Primary practice location

1 Memorial Dr
Physcians Plaza East Ste 110
Decatur, IL 62526-6303

Mailing address

3798 E. Fulton Ave
Decatur, IL 62521
Phone (217) 864-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160512000648 MO Practitioner - Physician Assistant 6002898715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christopher Kling, M.D., Inc.Group PAC ID 7113072414, 4 clinicians

Practice addresses (Care Compare)

16759 Main St
Wildwood, MO 63040-1232
Phone (636) 821-1661

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
385000284ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Berkshire Faculty Services Inc PastSince Aug 1, 2005 Accepting new patients
Decatur Memorial Hospital Past Accepting new patients
Decatur Memorial Hospital Past Accepting new patients
JMS Hand Associates, S.C. Past Accepting new patients

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": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1306026224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3798 E. FULTON AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "62521",
            "telephone_number": "217-864-2700",
            "fax_number": "217-864-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEMORIAL DR",
            "address_2": "PHYSCIANS PLAZA EAST STE 110",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625266303",
            "telephone_number": "217-422-2442",
            "fax_number": "217-424-9431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "JULIE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-08",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "385000284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.