Active NPI
Marc Douglas Knepp, M.D.
- Pediatric Cardiology Physician
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- License
- 036-129846
- Practice address
- 420 NE Glen Oak Ave
Suite 301
Peoria, IL 61603-3105 - Phone
- (309) 655-3456
- Fax
- (309) 655-3410
- NPI assigned
- Apr 12, 2007
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 4301083662 | MI | |
| Internal Medicine Physician | 207R00000X | 4301083662 | MI | |
| Pediatrics Physician | 208000000X | 4301083662 | MI | |
| Pediatric Cardiology Physician | 2080P0202X | 036-129846 | IL | Primary |
Addresses
Primary practice location
420 NE Glen Oak Ave
Suite 301
Peoria, IL 61603-3105
Mailing address
420 NE Glen Oak Ave
Suite 301
Peoria, IL 61603-3105
Phone (309) 655-3453
Other practice location 1
1000 Health Center Dr
Mattoon, IL 61938-4644
Phone (217) 238-4960
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Illini Dr
Peoria, IL 61605-2576
Phone (309) 671-8484
420 Neglen Oak Ave
Suite 301
Peoria, IL 61603
Phone (309) 655-3453
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-129846 | IL | MD | Pediatric Cardiology Physician |
| 4301083662 | MI | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sarah Bush Lincoln Health Center | Current | Accepting new patients | |
| Board of Trustees of the University of Illinois | Internal Medicine | Current | Accepting new patients |
| Sarah Bush Lincoln Health Center | Current | Accepting new patients | |
| Hoopeston Community Memorial Hospital | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Internal Medicine | Current | Accepting new patients |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| Genesis Health System | Current | Accepting new patients | |
| Hoopeston Community Memorial Hospital | Current | Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| Carle Health Care Incorporated | Internal Medicine | Current | Accepting new patients |
| Hoopeston Community Memorial Hospital | Internal Medicine | Current | Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Cardinal Medical Group, LTD. | Past | Accepting new patients |
Locations
7694 Solutions Ctr
Chicago, IL 60677
215 E 1st St
Ste 105
Dixon, IL 61021
Phone (815) 285-5603
837 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5530
701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531
101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730
1000 Health Center Dr
Ste H
Mattoon, IL 61938
1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389
1000 Medical Center Dr
Monticello, IL 61856
Phone (217) 762-1540
420 NE Glen Oak Ave
Ste 304
Peoria, IL 61603
Phone (877) 464-6640
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
1 Illini Dr
Peoria, IL 61605
Phone (309) 671-3000
420 NE Glen Oak Ave
Ste 301
Peoria, IL 61603
Phone (309) 655-7668
420 NE Glen Oak Ave
Ste 30
Peoria, IL 61603
444 Roxbury Rd
Rockford, IL 61107
Phone (815) 395-9196
444 Roxbury Rd
#12471
Rockford, IL 61107
801 Illini Dr
Silvis, IL 61282
Phone (309) 281-4000
2524 Farragut Dr
Springfield, IL 62704
Phone (217) 726-9020
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
1405 W Park St
Urbana, IL 61801
Phone (217) 337-3240
Interoperability endpoints
- mknepp34223@cghmc.direct-ci.com
Organizations & group practices 14
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
- Anatomic Pathology Physician
- Chicago, IL
- NPI 1386863819
-
dba Carle Physician Group
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
-
dba Genesis Medical Center - Silvis
- General Acute Care Hospital
- Silvis, IL
- NPI 1427132604
-
dba Hoopeston Physician Group
- Internal Medicine Physician
- Hoopeston, IL
- NPI 1043683014
-
- General Acute Care Hospital
- Mattoon, IL
- NPI 1669564662
-
dba Medical Service Plan at Peoria
- Pediatrics Physician
- Peoria, IL
- NPI 1467425322
Internal Medicine
-
- Critical Access Hospital
- Hoopeston, IL
- NPI 1366480873
-
dba Charlotte Ann Russell Medical Center
- Rural Health Clinic/Center
- Hoopeston, IL
- NPI 1578504544
-
dba FCH Greenville Family Medicine Clinic
- Rural Health Clinic/Center
- Greenville, IL
- NPI 1811858970
-
dba Occupational Health Service Institute (OHSI)
- Occupational Medicine Physician
- Chicago, IL
- NPI 1043727571
-
dba patton pharmacy and v&s variety
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba OSF Saint Anthony Medical Center
- General Acute Care Hospital
- Rockford, IL
- NPI 1790739977
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668124800000",
"number": "1568686277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 NE GLEN OAK AVE",
"address_2": "SUITE 301",
"city": "PEORIA",
"state": "IL",
"postal_code": "616033105",
"telephone_number": "309-655-3453",
"fax_number": "309-655-3410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 NE GLEN OAK AVE",
"address_2": "SUITE 301",
"city": "PEORIA",
"state": "IL",
"postal_code": "616033105",
"telephone_number": "309-655-3456",
"fax_number": "309-655-3410"
}
],
"practiceLocations": [
{
"address_1": "1000 Health Center Dr",
"address_purpose": "LOCATION",
"city": "Mattoon",
"state": "IL",
"postal_code": "619384644",
"country_code": "US",
"telephone_number": "217-238-4960",
"fax_number": "217-238-4951",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KNEPP",
"first_name": "MARC",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-12",
"last_updated": "2022-11-11",
"certification_date": "2022-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "4301083662",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301083662",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301083662",
"primary": false
},
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "IL",
"license": "036-129846",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.