NPIMap

Organization Active NPI

Epss LLC - Central Series

  • Emergency Medicine Physician
  • Pekin, IL
National Provider Identifier
1538680467
Registry record updated Jun 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036098328 Issued in IL
Legal business name
EPSS LLC - CENTRAL SERIES
Practice address
600 S 13TH St
Pekin, IL 61554-4936
Phone
(817) 451-4208
Fax
(817) 563-3699
NPI assigned
Jun 30, 2017
Last updated
Jun 30, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2017

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

Authorized official

Name
Dr. James T Hubler, MD
Title
Owner/President
Phone
(817) 451-4208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036098328 IL Primary

Addresses

Primary practice location

600 S 13TH St
Pekin, IL 61554-4936

Mailing address

6300 Ridglea PL Ste 201
Fort Worth, TX 76116-5707
Phone (817) 451-4208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171110002604 IL Part B Supplier - Clinic/Group Practice 6204192016 Receives reassigned benefits from 95 practitioners
Practice locations: Pekin, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 95

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 95

NPI Registry JSON

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498780800000",
    "number": "1538680467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 RIDGLEA PL STE 201",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761165707",
            "telephone_number": "18174514208",
            "fax_number": "817-563-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S 13TH ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615544936",
            "telephone_number": "817-451-4208",
            "fax_number": "817-563-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPSS LLC - CENTRAL SERIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-30",
        "last_updated": "2017-06-30",
        "status": "A",
        "authorized_official_last_name": "HUBLER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "817-451-4208",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036098328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pekin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.