NPIMap

Organization Active NPI

Springfield Obstetric & Gynecologic Associates, S.C.

  • Obstetrics & Gynecology Physician
  • Springfield, IL
National Provider Identifier
1306822093
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
SPRINGFIELD OBSTETRIC & GYNECOLOGIC ASSOCIATES, S.C.
Practice address
350 W Carpenter St
Springfield, IL 62702-4902
Phone
(217) 525-0210
Fax
(217) 525-1007
NPI assigned
Dec 15, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Edward Michael Bradley, M.D.NPI 1497744171
Title
President
Phone
(217) 525-0210

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)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X IL Primary

Addresses

Primary practice location

350 W Carpenter St
Springfield, IL 62702-4902

Mailing address

350 W Carpenter St
Springfield, IL 62702-4902
Phone (217) 525-0210

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1134604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306822093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024902",
            "telephone_number": "217-525-0210",
            "fax_number": "217-525-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024902",
            "telephone_number": "217-525-0210",
            "fax_number": "217-525-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGFIELD OBSTETRIC & GYNECOLOGIC ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-525-0210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.