NPIMap

Individual provider Active NPI

Mark M Spangler, MD

  • Family Medicine Physician
  • Gibson City, IL
National Provider Identifier
1336208347
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036092859 Issued in IL
Practice address
3 Doctors Park
Gibson City, IL 60936-2000
Phone
(217) 784-4030
Fax
(217) 784-4405
NPI assigned
Dec 6, 2006
Last updated
Aug 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036092859 IL Primary

Addresses

Primary practice location

3 Doctors Park
Gibson City, IL 60936-2000

Mailing address

3 Doctors Park
Gibson City, IL 60936-2000
Phone (217) 784-4030

Other identifiers 1

IdentifierTypeStateIssuer
036092859MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mark.Spangler.p37@direct.gapho.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110311000201 IL Practitioner - Family Practice 1658405683 Reassigns benefits to 2 organizations
Practice locations: Gibson City, IL

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Washington University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Doctors Park
Gibson City, IL 60936-2000
Phone (217) 784-4297

1120 N Melvin St
Gibson City, IL 60936-1477

1504 Patton Dr
Suite 2
Mahomet, IL 61853-8126
Phone (217) 586-2633

221 Wal Crest Dr
Fairbury, IL 61739-8998
Phone (815) 692-1150

227 N Market St
Paxton, IL 60957-1123
Phone (217) 379-4864

3 Doctors Park
Gibson City, IL 60936-2000
Phone (217) 784-4030

4 Doctors Park
Gibson City, IL 60936-2000
Phone (217) 784-4251

7 Doctors Park
Gibson City, IL 60936-2000
Phone (217) 784-5500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association Family Medicine CurrentSince Jul 6, 2015 Accepting new patients
Gibson Community Hospital Association Current Accepting new patients
Gibson Community Hospital Association CurrentSince Jul 6, 2015 Accepting new patients
Gibson Community Hospital Association Current Accepting new patients
Gibson Community Hospital Association Family Medicine Past Accepting new patients

Locations

1230 George Rock Dr
Farmer City, IL 61842
Phone (309) 928-9192

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

3 Doctors Park
Gibson City, IL 60936
Phone (217) 784-4030

7 Doctors Park
Gibson City, IL 60936
Phone (217) 784-5500

1504 Patton Dr
Ste 2
Mahomet, IL 61853
Phone (217) 586-2633

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Gibson Area Hospital & Health ServicesGibson City, IL, CCN 141317 Hospital Corporate Director Nov 1, 2022
Gibson Area Hospital & Health ServicesGibson City, IL, CCN 14Z317 Hospital Corporate Director Nov 1, 2022
Gibson Area Medical ClinicGibson City, IL, CCN 148546 Rural health clinic Corporate Officer Nov 1, 2022
Family Health Care of Cissna ParkCissna Park, IL, CCN 148593 Rural health clinic Corporate Director Nov 1, 2022
Family Health Care of MahometMahomet, IL, CCN 148600 Rural health clinic Corporate Director Nov 1, 2022
Family Health Care of WatsekaWatseka, IL, CCN 148609 Rural health clinic Corporate Officer Oct 1, 2022

Owned or controlled facilities with NPI records 24

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 24

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1336208347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 DOCTORS PARK",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609362000",
            "telephone_number": "217-784-4030",
            "fax_number": "217-784-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 DOCTORS PARK",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609362000",
            "telephone_number": "217-784-4030",
            "fax_number": "217-784-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANGLER",
        "first_name": "MARK",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036092859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036092859",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.Spangler.p37@direct.gapho.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3 Doctors Park",
            "city": "Gibson City",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609362000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gibson City, IL

Sources for this page

Verify at the official NPI Registry.