Decatur Orthopedic Center, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

DECATUR ORTHOPEDIC CENTER, LLC

Practice address

104 E Ashland Ave
Mt Zion, IL 62549-1271

Phone

(217) 864-2665

Fax

(217) 864-8042

NPI assigned

Jan 26, 2021

Organization subpart

No

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

Authorized official

Name

Shelly Doyle

Title

Office Manager

Phone

(217) 864-8364

Specialties & licenses 1

Addresses

Tax ID family

Decatur Orthopedic Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Decatur Orthopedic Center, LLC

  • Non-Pharmacy Dispensing Site
  • Mt Zion, IL
  • NPI 1720736002
  NPD tax ID

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611619200000",
    "number": "1568053296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E ASHLAND AVE",
            "city": "MT ZION",
            "state": "IL",
            "postal_code": "625491271",
            "telephone_number": "217-864-2665",
            "fax_number": "217-864-8042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E ASHLAND AVE",
            "city": "MT ZION",
            "state": "IL",
            "postal_code": "625491271",
            "telephone_number": "217-864-2665",
            "fax_number": "217-864-8042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR ORTHOPEDIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A",
        "authorized_official_last_name": "DOYLE",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "217-864-8364"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher J Woodrow, D.C., P.C.
• Tosha Cobb, LMT
• Todd J Cole, DDS
• Decatur Family Medical Group Inc
• Decatur Orthopedic Center, LLC
• Decatur Orthopedic Center, LLC
• Dolly Briscoe Enterprises, Inc.
• Courtney Doty, PTA
• Amy Fink, PTA
• Dustin Joseph Fink, MS, ATC

• All providers in Mt Zion, IL
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.