Individual provider Active NPI

Edith Fraley, M.D., FACEP

  • Emergency Medicine Physician
  • Springfield, IL
National Provider Identifier
1629095187
Registry record updated Feb 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Practice address
800 E Carpenter St
Springfield, IL 62769-0002
Phone
(217) 464-2966
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2008

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X T8340 MO
Emergency Medicine Physician 207P00000X C-5539 AR
Emergency Medicine Physician 207P00000X MD-041041-E PA
Emergency Medicine Physician 207P00000X 168603 NY
Emergency Medicine Physician 207P00000X 35-047370 OH
Emergency Medicine Physician 207P00000X 01030295A IN
Emergency Medicine Physician 207P00000X 15267 NE
Emergency Medicine Physician 207P00000X IL Primary

Addresses

Primary practice location

800 E Carpenter St
Springfield, IL 62769-0002

Mailing address

75 Remitt Drive
Lockbox 1374
Chicago, IL 60675-1374
Phone (866) 916-5259

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 Medicine

State licenses

LicenseStateTypeSpecialty
C-5539ARMDEmergency Medicine Physician
036-088130ILMDEmergency Medicine Physician
01030295AINMDEmergency Medicine Physician
T8340MOMDEmergency Medicine Physician
15267NEMDEmergency Medicine Physician
168603NYMDEmergency Medicine Physician
35-047370OHMDEmergency Medicine Physician
MD-041041-EPAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BC Missouri Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
Central Illinois Emergency Physicians, LLP Emergency Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202428800000",
    "number": "1629095187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMITT DRIVE",
            "address_2": "LOCKBOX 1374",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606751374",
            "telephone_number": "866-916-5259",
            "fax_number": "231-922-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627690002",
            "telephone_number": "217-464-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRALEY",
        "first_name": "EDITH",
        "credential": "M.D., FACEP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "T8340",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "C-5539",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD-041041-E",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "168603",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35-047370",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01030295A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "15267",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2008; 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.