NPIMap

Organization Active NPI

St Marys Hospital Decatur of the Hospital Sisters of the Third Order

  • Internal Medicine Physician
  • Decatur, IL
National Provider Identifier
1316188485
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER
Practice address
2981 N Main St
Decatur, IL 62526-3259
Phone
(217) 877-9775
Fax
(217) 877-9806
NPI assigned
Mar 18, 2009
Last updated
Oct 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Mark D Evard
Title
VP of Revenue Cycle
Phone
(217) 492-9651

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2981 N Main St
Decatur, IL 62526-3259

Mailing address

3051 Hollis Dr
Springfield, IL 62704-7450
Phone (217) 877-9775

Other names 1

  • Macon County Medical Associates at St. Mary's Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address st_marys_decatur_toc2202619@ewd.direct.hshs.org Direct

National Provider Directory

National Provider Directory
Tax ID family
St Marys Hosp Non-Invas6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2981 N Main St
Decatur, IL 62526
Phone (217) 542-1293

NPI Registry JSON

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1316188485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 HOLLIS DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047450",
            "telephone_number": "217-877-9775",
            "fax_number": "217-877-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2981 N MAIN ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263259",
            "telephone_number": "217-877-9775",
            "fax_number": "217-877-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-18",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "EVARD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE",
        "authorized_official_telephone_number": "217-492-9651"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "st_marys_decatur_toc2202619@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1800 E Lake Shore Dr",
            "city": "Decatur",
            "state": "IL",
            "country_code": "US",
            "postal_code": "625213810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Macon County Medical Associates at St. Mary's",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Macon County Medical Associates at St. Mary's",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.