Individual provider Active NPI

Victoria Oluwakemi Famuyide, DO

  • Pulmonary Disease Physician
  • Urbana, IL
National Provider Identifier
1497999627
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
036147265 Issued in IL
Practice address
611 W Park St
Urbana, IL 61801-2501
Phone
(217) 383-3190
Fax
(217) 383-7117
NPI assigned
May 1, 2009
Last updated
Dec 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 036147265 IL Primary

Addresses

Primary practice location

611 W Park St
Urbana, IL 61801-2501

Mailing address

611 W Park St
Fapc
Urbana, IL 61801-2500

Other practice location 1

5100 W Broad St
Columbus, OH 43228-1607
Phone (614) 544-2091

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181119000645 IL Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 5890944896 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Critical Care (Intensivists), Pulmonary Disease
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

100 Lerna S Rd
Mattoon, IL 61938-9384
Phone (217) 258-5900

516 W Madison St
Danville, IL 61832-5657

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036147265ILMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Medical Group Pulmonary Disease CurrentSince Oct 1, 2018 Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Apr 1, 2020 Accepting new patients
Kirby Medical Center CurrentSince Nov 2, 2019 Accepting new patients
Richland Memorial Hospital, Inc Current Accepting new patients
Kirby Medical Center CurrentSince Nov 2, 2019 Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Apr 1, 2020 Accepting new patients
Carle Health Care Incorporated Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

1000 Medical Center Dr
Monticello, IL 61856
Phone (217) 762-1540

800 E Locust St
Olney, IL 62450
Phone (618) 395-2131

900 E Scott St
Olney, IL 62450
Phone (618) 345-1000

1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1241136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1497999627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012501",
            "telephone_number": "217-383-3190",
            "fax_number": "217-383-7117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5100 W Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432281607",
            "country_code": "US",
            "telephone_number": "614-544-2091",
            "fax_number": "614-544-1751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAMUYIDE",
        "first_name": "VICTORIA",
        "middle_name": "OLUWAKEMI",
        "name_prefix": "Ms.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-01",
        "last_updated": "2023-12-01",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036147265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.