Active NPI
Wayne Zimmer McBride, D.O.
- Family Medicine Physician
- Bloomington, IL
National Provider Identifier
1568434009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036-129395
- Practice address
- 6 Windsong Way
Bloomington, IL 61704-8350 - Phone
- (309) 585-2485
- NPI assigned
- Feb 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036-129395 | IL | Primary |
Addresses
Primary practice location
6 Windsong Way
Bloomington, IL 61704-8350
Mailing address
6 Windsong Way
Bloomington, IL 61704-8350
Phone (309) 585-2485
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-129395 | IL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383004800000",
"number": "1568434009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 WINDSONG WAY",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617048350",
"telephone_number": "309-585-2485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 WINDSONG WAY",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617048350",
"telephone_number": "309-585-2485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCBRIDE",
"first_name": "WAYNE",
"middle_name": "ZIMMER",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-07",
"last_updated": "2013-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036-129395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.