Individual provider Active NPI

Donald G. Adams, M.D.

  • Family Medicine Physician
  • Belleville, IL
National Provider Identifier
1508842352
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036129376 Issued in IL
Practice address
130 Lincoln Place CT Ste 130
Belleville, IL 62221-5884
Phone
(618) 257-1297
NPI assigned
Dec 22, 2005
Last updated
Feb 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036129376 IL Primary

Addresses

Primary practice location

130 Lincoln Place CT Ste 130
Belleville, IL 62221-5884

Mailing address

130 Lincoln Place CT Ste 130
Belleville, IL 62221-5884
Phone (618) 257-1297

Other practice location 1

333 S Illinois St
Ste. A
Belleville, IL 62220-2153
Phone (618) 277-4888

Other identifiers 10

IdentifierTypeStateIssuer
E2001OtherNCMEDCOST
0105902OtherNCUNITED HEALTHCARE
P00251903OtherRAIL ROAD MEDICARE
2439407867OtherNCCHAMPUS/TRICARE
4115662OtherNCAETNA
139TVOtherNCBCBS
036129376MedicaidIL
1549555OtherNCCIGNA
5900917MedicaidNC
806067OtherNCPARTNERS MEDICARE CHOICE

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

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
I20120224000459 IL Practitioner - Family Practice 6901864230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wake Forest University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

130 Lincoln Place CT
Suite 130
Belleville, IL 62221-5884
Phone (618) 257-1297

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC CurrentSince Dec 24, 2017 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Aug 15, 2023 Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients
PC Associates, LLC Family Medicine Past Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

130 Lincoln Place Ct
Ste 130
Belleville, IL 62221
Phone (618) 257-1297

4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750

660 Mason Ridge Center Dr
Saint Louis, MO 63141
Phone (314) 273-6481

Interoperability endpoints

  • Direct secure messaging: dadams170894@direct.carenet.org

Organizations & group practices 5

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 5

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1508842352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 LINCOLN PLACE CT STE 130",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622215884",
            "telephone_number": "618-257-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LINCOLN PLACE CT STE 130",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622215884",
            "telephone_number": "618-257-1297"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 S Illinois St",
            "address_2": "Ste. A",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622202153",
            "country_code": "US",
            "telephone_number": "618-277-4888",
            "fax_number": "618-277-1190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "DONALD",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036129376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "E2001",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0105902",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00251903",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS/TRICARE",
            "identifier": "2439407867",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4115662",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "139TV",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036129376",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1549555",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900917",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS MEDICARE CHOICE",
            "identifier": "806067",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "130 Lincoln Place Ct Ste 130",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622215884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.