Individual provider Active NPI

David W Reem, MD

  • Internal Medicine Physician
  • Macomb, IL
National Provider Identifier
1336124668
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-049838 Issued in IL
Practice address
515 E Grant St
Suite 111
Macomb, IL 61455-3315
Phone
(309) 837-9926
Fax
(309) 833-1417
NPI assigned
Dec 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-049838 IL Primary

Addresses

Primary practice location

515 E Grant St
Suite 111
Macomb, IL 61455-3315

Mailing address

515 E Grant St
Suite 111
Macomb, IL 61455-3315
Phone (309) 837-9926

Other identifiers 2

IdentifierTypeStateIssuer
05532012OtherILBCBS OF IL
0360498351MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-049838ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Current Accepting new patients

Locations

525 E Grant St
Macomb, IL 61455
Phone (309) 836-1611

515 E Grant St
Ste 112
Macomb, IL 61455
Phone (309) 833-4104

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9c9d3cdf-0f7f-4b63-979a-f711747b3e95/

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": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1336124668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 E GRANT ST",
            "address_2": "SUITE 111",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614553315",
            "telephone_number": "309-837-9926",
            "fax_number": "309-833-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E GRANT ST",
            "address_2": "SUITE 111",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614553315",
            "telephone_number": "309-837-9926",
            "fax_number": "309-833-1417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEM",
        "first_name": "DAVID",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-049838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "05532012",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360498351",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; 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.