NPIMap

Organization Active NPI

Methodist Medical Center of Illinois

Doing business as Methodist Emergency Services

  • Emergency Medicine Physician
  • Peoria, IL
National Provider Identifier
1326765694
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
METHODIST MEDICAL CENTER OF ILLINOIS
Doing business as
Methodist Emergency Services
Practice address
221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone
(309) 672-5522
NPI assigned
Oct 26, 2022
Last updated
Oct 26, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
METHODIST MEDICAL CENTER OF ILLINOISAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Authorized official

Name
Dr. Keith Knepp, MD
Title
Ceo
Phone
(309) 671-2528

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

221 NE Glen Oak Ave
Peoria, IL 61636-0001

Mailing address

221 NE Glen Oak Ave # Gomp100
Peoria, IL 61636-0001
Phone (309) 672-5522

Other names 1

  • Methodist Emergency Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Michele H Moody MD11 organizations share this tax ID, including this one
Part of
Michele H Moody MD

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1326765694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE # GOMP100",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001",
            "telephone_number": "309-672-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001",
            "telephone_number": "309-672-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST MEDICAL CENTER OF ILLINOIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METHODIST MEDICAL CENTER OF ILLINOIS",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "KNEPP",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-671-2528",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Methodist Emergency Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.