Organization Active NPI

Ryan D. Schmidgall, S.C.

  • Family Medicine Physician
  • Washington, IL
National Provider Identifier
1386664381
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RYAN D. SCHMIDGALL, S.C.
Practice address
50 Valley Forge Rd
Washington, IL 61571-2372
Phone
(309) 444-8447
Fax
(309) 444-2003
NPI assigned
Jul 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Authorized official

Name
Ryan Daniel Schmidgall, M.D.NPI 1548204779
Title
Owner
Phone
(309) 444-8447

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X IL Primary

Addresses

Primary practice location

50 Valley Forge Rd
Washington, IL 61571-2372

Mailing address

50 Valley Forge Rd
Washington, IL 61571-2372
Phone (309) 444-8447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060724000279 IL Part B Supplier - Clinic/Group Practice 2466465117 Receives reassigned benefits from 1 practitioner
Practice locations: Peoria, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1386664381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 VALLEY FORGE RD",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615712372",
            "telephone_number": "309-444-8447",
            "fax_number": "309-444-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 VALLEY FORGE RD",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615712372",
            "telephone_number": "309-444-8447",
            "fax_number": "309-444-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN D. SCHMIDGALL, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "SCHMIDGALL",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-444-8447",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.