Active NPI
Antonio Alberto Cummings, M.D.
- Emergency Medicine Physician
- Carbondale, IL
National Provider Identifier
1427369313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 036.131709
- Practice address
- 405 W Jackson St
Carbondale, IL 62901 - Phone
- (618) 549-0721
- Fax
- (618) 457-0469
- NPI assigned
- Jun 25, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 125.057966 | IL | |
| Emergency Medicine Physician | 207P00000X | 036131709 | IL | |
| Emergency Medicine Physician | 207P00000X | 036.131709 | IL | Primary |
Addresses
Primary practice location
405 W Jackson St
Carbondale, IL 62901
Mailing address
1239 E Main St
Carbondale, IL 62901-3175
Phone (618) 457-5200
Other practice location 1
201 S 14th St
Herrin, IL 62948-3631
Phone (618) 942-2171
Other practice location 2
2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-3156
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036.131709 | Medicaid | IL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 036.131709 | IL | MD | Emergency Medicine Physician |
| 125.057966 | IL | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570579200000",
"number": "1427369313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1239 E MAIN ST",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629013175",
"telephone_number": "618-457-5200",
"fax_number": "618-529-0586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 W JACKSON ST",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "62901",
"telephone_number": "618-549-0721",
"fax_number": "618-457-0469"
}
],
"practiceLocations": [
{
"address_1": "201 S 14th St",
"address_purpose": "LOCATION",
"city": "Herrin",
"state": "IL",
"postal_code": "629483631",
"country_code": "US",
"telephone_number": "618-942-2171",
"fax_number": "618-351-4917",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2 S Hospital Dr",
"address_purpose": "LOCATION",
"city": "Murphysboro",
"state": "IL",
"postal_code": "629663333",
"country_code": "US",
"telephone_number": "618-684-3156",
"fax_number": "618-529-0524",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CUMMINGS",
"first_name": "ANTONIO",
"middle_name": "ALBERTO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-25",
"last_updated": "2019-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "125.057966",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036131709",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036.131709",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036.131709",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Carbondale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.