Philip Zumwalt,M.D.

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

PHILIP ZUMWALT,M.D.

Practice address

125 S 4TH St
Watseka, IL 60970-1601

Phone

(815) 432-5430

Fax

(815) 432-6024

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Philip Frank Zumwalt, M.D.NPI 1629066170

Title

Owner/Physician

Phone

(815) 432-5430

Specialties & licenses 1

Addresses

Other names 1

• WATSEKA FAMILY PRACTICE Doing business as

Locations

Practitioners 3

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

• Philip Frank Zumwalt, M.D.

  • Family Medicine Physician
  • Watseka, IL
  • NPI 1629066170
  NPD (past) Authorized official
• Miragene Brosseau, N.P.

  • Adult Health Nurse Practitioner
  • Watseka, IL
  • NPI 1578733556
  NPD (past)
• Marcy E Zumwalt, N.P.

  • Family Nurse Practitioner
  • Watseka, IL
  • NPI 1720258882
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223424000000",
    "number": "1508946112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S 4TH ST",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701601",
            "telephone_number": "815-432-5430",
            "fax_number": "815-432-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S 4TH ST",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701601",
            "telephone_number": "815-432-5430",
            "fax_number": "815-432-6024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP ZUMWALT,M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-10-08",
        "status": "A",
        "authorized_official_last_name": "ZUMWALT",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "FRANK",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "815-432-5430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WATSEKA FAMILY PRACTICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Austin L Pendry
• Petersen Health Care II, Inc
• Petersen Health Operations, LLC
• Jeffrey W. Petersen, ATC
• Casimir Edward Petkunas III, MSW, LSW
• Denise Pillot
• Issac G. Plamoottil, M.D.
• Peter Joseph Pollachek, A.P.N.
• Michael T Potter, BA
• Lauren Prince

• Rural Health Clinic/Center in Watseka, IL
• Providers in Watseka, IL by specialty
• Rural Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.