Active NPI
Ryan Peddy
- Family Medicine Physician
- Urbana, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 125.066971
- Practice address
- 611 W Park St
Urbana, IL 61801-2529 - Phone
- (217) 383-3170
- NPI assigned
- Jun 16, 2015
- Last updated
- Jun 17, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 125.066971 | IL | Primary |
Addresses
Primary practice location
611 W Park St
Urbana, IL 61801-2529
Mailing address
1905 N Lincoln Ave
Apt 122
Urbana, IL 61801-1012
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 Lerna Rd S
Mattoon, IL 61938-9388
Phone (217) 258-5900
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
701 E Orange St
Hoopeston, IL 60942-1801
Phone (217) 283-5531
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.066971 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hoopeston Community Memorial Hospital | Current | Accepting new patients | |
| Hoopeston Community Memorial Hospital | Family Medicine | Current | Accepting new patients |
| Carle Health Medical Group | Family Medicine | Current | Accepting new patients |
| Hoopeston Community Memorial Hospital | Current | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531
301 E Southline Rd
Tuscola, IL 61953
Phone (217) 253-3426
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
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.
-
dba Carle Physician Group
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
Family Medicine
-
dba Hoopeston Physician Group
- Internal Medicine Physician
- Hoopeston, IL
- NPI 1043683014
Family Medicine
-
- Critical Access Hospital
- Hoopeston, IL
- NPI 1366480873
-
dba Charlotte Ann Russell Medical Center
- Rural Health Clinic/Center
- Hoopeston, IL
- NPI 1578504544
-
dba Gibson Area Hospital and Health Services
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Hoopeston Community Ambulance
- Ambulance
- Hoopeston, IL
- NPI 1164594594
Hospital
-
- Critical Access Hospital
- Hoopeston, IL
- NPI 1366480873
-
- General Acute Care Hospital
- Mattoon, IL
- NPI 1669564662
-
dba Sarah Bush Lincoln Home Care
- Home Health Agency
- Charleston, IL
- NPI 1922190024
-
- General Acute Care Hospital
- Urbana, IL
- NPI 1013071653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434499200000",
"number": "1346621257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1905 N LINCOLN AVE",
"address_2": "APT 122",
"city": "URBANA",
"state": "IL",
"postal_code": "618011012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 W PARK ST",
"city": "URBANA",
"state": "IL",
"postal_code": "618012529",
"telephone_number": "217-383-3170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDDY",
"first_name": "RYAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-16",
"last_updated": "2015-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "125.066971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Urbana, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.