Sam Gaines P C

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SAM GAINES P C

Practice address

120 N 11TH St
Springfield, IL 62703-1002

Phone

(217) 544-9858

NPI assigned

Jul 22, 2025

Organization subpart

No

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

Authorized official

Name

Sam Gaines, MDNPI 1730115643

Title

Owner

Phone

(217) 341-1726

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

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

• Sam Gaines, M.D.

  • Internal Medicine Physician
  • Normal, IL
  • NPI 1730115643
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1753142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753142400000",
    "number": "1487536314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 COLBROOK DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N 11TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627031002",
            "telephone_number": "217-544-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM GAINES P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-22",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-15",
        "status": "A",
        "authorized_official_last_name": "GAINES",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-341-1726",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ezzeldin A Saleh, MD
• Nabeel Salka, MD, MSE
• Jared Salrin, MS3
• Laurie Ann Salvacion, P.T.
• Salve Regina Center
• Sam'S Club Optical
• Billee L Samples, PHARMD
• Sams West Inc
• Gregg Sams
• Lucy Sams, PT, DPT

• Internal Medicine Physician in Springfield, IL
• Providers in Springfield, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.