Active NPI
Thomas Golemon, MD
- Family Medicine Physician
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Practice address
- 815 Main St
Peoria, IL 61602-1076 - Phone
- (309) 672-4977
- NPI assigned
- Jul 28, 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 | IL | Primary |
Addresses
Primary practice location
815 Main St
Peoria, IL 61602-1076
Mailing address
5100 Reliable Pkwy
Chicago, IL 60686-0001
Phone (309) 672-4809
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008424 | Other | IL | HEALTH ALLIANCE |
| 0360784678 | Medicaid | IL | |
| IL01P6 | Other | IL | JOHN DEERE |
| 7215059 | Other | IL | BCBS PPO |
| 472301 | Other | IL | HEALTHLINK |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036078467 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Methodist Medical Center of Illinois | Current | Accepting new patients | |
| Proctor Health Systems | Family Medicine | Current | Accepting new patients |
| Methodist Medical Center of Illinois | Current | Accepting new patients | |
| Proctor Health Systems | Family Medicine | Current | Accepting new patients |
| Methodist Medical Center of Illinois | Family Medicine | Past | Accepting new patients |
Locations
5100 Reliable Pkwy
Chicago, IL 60686
Phone (309) 672-4809
112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 680-2402
815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986
221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281
815 Main St
Ste A1
Peoria, IL 61602
815 Main St
Peoria, IL 61602
Phone (309) 672-4908
5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rehabilitation Hospital Unit
- Peoria, IL
- NPI 1982656575
-
- Family Medicine Physician
- Peoria, IL
- NPI 1134173917
-
- General Acute Care Hospital
- Peoria, IL
- NPI 1164474755
-
- Family Medicine Physician
- Peoria, IL
- NPI 1184670663
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619981370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5100 RELIABLE PKWY",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606860001",
"telephone_number": "309-672-4809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 MAIN ST",
"city": "PEORIA",
"state": "IL",
"postal_code": "616021076",
"telephone_number": "309-672-4977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLEMON",
"first_name": "THOMAS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE",
"identifier": "008424",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0360784678",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "IL01P6",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PPO",
"identifier": "7215059",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "472301",
"state": "IL"
}
],
"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 Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.