Active NPI
Edith Fraley, M.D., FACEP
- Emergency Medicine Physician
- Springfield, IL
National Provider Identifier
1629095187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| C-5539 | AR | MD | Emergency Medicine Physician |
| 036-088130 | IL | MD | Emergency Medicine Physician |
| 01030295A | IN | MD | Emergency Medicine Physician |
| T8340 | MO | MD | Emergency Medicine Physician |
| 15267 | NE | MD | Emergency Medicine Physician |
| 168603 | NY | MD | Emergency Medicine Physician |
| 35-047370 | OH | MD | Emergency Medicine Physician |
| MD-041041-E | PA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Emergency Medicine Physician
- Springfield, IL
- NPI 1740205699
-
- Emergency Medicine Physician
- Sullivan, MO
- NPI 1679598247
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.