Individual provider Active NPI

John Peder Littlefield, P.A.

  • Physician Assistant
  • Beloit, WI
National Provider Identifier
1467867358
Registry record updated Dec 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3474-23 Issued in WI
Practice address
1905 E Huebbe Pkwy
Beloit Health System Inc
Beloit, WI 53511-1842
Phone
(608) 364-2230
Fax
(608) 363-7374
NPI assigned
Jun 30, 2014
Last updated
Dec 19, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-005209 IL
Physician Assistant 363A00000X 3474-23 WI Primary

Addresses

Primary practice location

1905 E Huebbe Pkwy
Beloit Health System Inc
Beloit, WI 53511-1842

Mailing address

1905 E Huebbe Pkwy
Beloit Health System Inc
Beloit, WI 53511-1842
Phone (608) 364-2230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150126000968 IL Practitioner - Physician Assistant 1355665266 Reassigns benefits to 3 organizations
I20150204001392 WI Practitioner - Physician Assistant 1355665266 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-005209ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beloit Health System Inc CurrentSince Dec 22, 2014 Accepting new patients
Beloit Clinic, S.C. Current Accepting new patients
Beloit Health System, Inc CurrentSince Aug 1, 2014 Accepting new patients
Wellnow Urgent Care, PC CurrentSince Dec 30, 2024 Accepting new patients
Beloit Health System, Inc CurrentSince Aug 1, 2014 Accepting new patients

Locations

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

5605 E Rockton Rd
Roscoe, IL 61073
Phone (815) 525-4000

1735 Madison Rd
Beloit, WI 53511
Phone (608) 363-7510

1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/f4477d7c-dbb4-4046-92c9-1cc56c248ecb/

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418947200000",
    "number": "1467867358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 E HUEBBE PKWY",
            "address_2": "BELOIT HEALTH SYSTEM INC",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-2230",
            "fax_number": "608-363-7374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 E HUEBBE PKWY",
            "address_2": "BELOIT HEALTH SYSTEM INC",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-2230",
            "fax_number": "608-363-7374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLEFIELD",
        "first_name": "JOHN",
        "middle_name": "PEDER",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-30",
        "last_updated": "2014-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-005209",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3474-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

Verify at the official NPI Registry.