Active NPI
Samuel L Hutson, MD
- Diagnostic Radiology Physician
- Springfield, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 036-139960
- Practice address
- 800 E Carpenter St
Springfield, IL 62769-5324 - Phone
- (217) 544-6464
- NPI assigned
- Jul 3, 2011
- Last updated
- Oct 23, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 036-139960 | IL | Primary |
Addresses
Primary practice location
800 E Carpenter St
Springfield, IL 62769-5324
Mailing address
111 Oakwood Rd
East Peoria, IL 61611-1853
Phone (309) 740-4272
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
- Diagnostic Radiology
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
800 E Carpenter St
Springfield, IL 62769-0001
Phone (217) 544-6464
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-139960 | IL | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Illinois Radiological Associates, LTD. | Diagnostic Radiology | Current | Accepting new patients |
| Maryville Imaging, LLC | Current | Accepting new patients | |
| Maryville Imaging, LLC | Current | Accepting new patients | |
| Cira Michigan PC | Diagnostic Radiology | Past | Accepting new patients |
Locations
5200 Reliable Pkwy
Chicago, IL 60686
Phone (309) 671-8748
5900 Bond Ave
East Saint Louis, IL 62207
Phone (618) 332-3060
111 Oakwood Rd
Peoria, IL 61611
114 W Stratford Dr
Ste E
Peoria, IL 61614
Phone (309) 740-4270
530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553
530neglen Oak Ave
Peoria, IL 61636
Phone (309) 685-1054
800 E Carpenter St
Springfield, IL 62769
Phone (217) 525-5643
800 E Carpenter St
Springfield, IL 62702
Phone (217) 525-5643
111 Spring St
Streator, IL 61364
Phone (815) 672-4587
Organizations & group practices 4
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 Central Illinois Radiological Associates
- Diagnostic Radiology Physician
- Peoria, IL
- NPI 1538192828
-
- Radiology Clinic/Center
- Maryville, IL
- NPI 1912293002
-
- Diagnostic Radiology Physician
- Escanaba, MI
- NPI 1972141513
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Maryville, IL
- NPI 1053481630
-
- Critical Access Hospital
- Staunton, IL
- NPI 1750308631
-
dba St. Anthony's Memorial Hospital
- General Acute Care Hospital
- Effingham, IL
- NPI 1306800602
-
dba St. Anthony's Memorial Hospitral
- Clinic/Center
- Effingham, IL
- NPI 1881214104
Hospital
-
dba HSHS St. Elizabeth's Hospital
- General Acute Care Hospital
- O'Fallon, IL
- NPI 1629057302
-
dba St Marys Hospital
- General Acute Care Hospital
- Decatur, IL
- NPI 1326041229
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698019200000",
"number": "1487941092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 OAKWOOD RD",
"city": "EAST PEORIA",
"state": "IL",
"postal_code": "616111853",
"telephone_number": "309-740-4272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E CARPENTER ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627695324",
"telephone_number": "217-544-6464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUTSON",
"first_name": "SAMUEL",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-03",
"last_updated": "2023-10-23",
"certification_date": "2023-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036-139960",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.