Individual provider Active NPI

Robert Brad Ringhofer, M.D.

  • Internal Medicine Physician
  • MC Leansboro, IL
National Provider Identifier
1528049889
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036063325 Issued in IL
Practice address
611 S Marshall Ave
MC Leansboro, IL 62859-1213
Phone
(618) 643-2361
Fax
(618) 643-2502
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036063325 IL Primary

Addresses

Primary practice location

611 S Marshall Ave
MC Leansboro, IL 62859-1213

Mailing address

PO Box 23340
Saint Louis, MO 63156-3340
Phone (618) 277-7500

Other identifiers 9

IdentifierTypeStateIssuer
2616OtherILBCBS TRI ST
C45531OtherILMERCY
000000010032OtherILESSENCE
036063325MedicaidIL
5950091OtherILAETNA
08221955OtherILBCBS
123506OtherILHEALTHLINK
127487OtherILGHP
0407154OtherILUHC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036063325ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Multispecialty Group Inc. Internal Medicine CurrentSince Aug 6, 1996 Accepting new patients
Washington University Past Accepting new patients
English and McLaughlin, P.C. Internal Medicine PastSince Aug 1, 2022 Accepting new patients

Locations

2900 Frank Scott Pkwy W
Ste 914
Belleville, IL 62223
Phone (618) 277-1413

1167 Fortune Blvd
Shiloh, IL 62269
Phone (618) 207-6900

4 Park Pl
Swansea, IL 62226
Phone (618) 277-7500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1528049889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23340",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631563340",
            "telephone_number": "618-277-7500",
            "fax_number": "618-277-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 S MARSHALL AVE",
            "city": "MC LEANSBORO",
            "state": "IL",
            "postal_code": "628591213",
            "telephone_number": "618-643-2361",
            "fax_number": "618-643-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RINGHOFER",
        "first_name": "ROBERT",
        "middle_name": "BRAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036063325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TRI ST",
            "identifier": "2616",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "C45531",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ESSENCE",
            "identifier": "000000010032",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036063325",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5950091",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "08221955",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "123506",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "127487",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "0407154",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Leansboro, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.