NPIMap

Organization Active NPI

Decatur Memorial Hospital

  • Cardiovascular Disease Physician
  • Decatur, IL
National Provider Identifier
1598094153
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
DECATUR MEMORIAL HOSPITAL
Doing business as
DMH Medical Group
Practice address
2300 N Edward St
Gsbll
Decatur, IL 62526-4163
Phone
(217) 876-2857
Fax
(217) 876-2874
NPI assigned
Dec 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Authorized official

Name
John W Ridley
Title
Ceo
Phone
(217) 876-2857

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

2300 N Edward St
Gsbll
Decatur, IL 62526-4163

Mailing address

2300 N Edward St
Gsbll
Decatur, IL 62526-4163
Phone (217) 876-2857

Other names 1

  • DMH Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Decatur Memroial Hospit6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409788800000",
    "number": "1598094153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST",
            "address_2": "GSBLL",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264163",
            "telephone_number": "217-876-2857",
            "fax_number": "217-876-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST",
            "address_2": "GSBLL",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264163",
            "telephone_number": "217-876-2857",
            "fax_number": "217-876-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2014-09-04",
        "status": "A",
        "authorized_official_last_name": "RIDLEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-876-2857"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DMH Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; 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.