NPIMap

Organization Active NPI

Decatur Memorial Hospital

  • Clinic/Center
  • Decatur, IL
National Provider Identifier
1639134117
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
DECATUR MEMORIAL HOSPITAL
Practice address
2300 N Edward St
Decatur, IL 62526-4163
Phone
(217) 876-2690
NPI assigned
Apr 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
James E Martinez, ATC, CSCS
Title
Athletic Trainer
Phone
(217) 358-2805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X IL Primary

Addresses

Primary practice location

2300 N Edward St
Decatur, IL 62526-4163

Mailing address

2230 W Ravina Park Rd
Decatur, IL 62526-3047
Phone (217) 358-2805

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639134117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 W RAVINA PARK RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263047",
            "telephone_number": "217-358-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264163",
            "telephone_number": "217-876-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ATHLETIC TRAINER",
        "authorized_official_telephone_number": "217-358-2805",
        "authorized_official_credential": "ATC, CSCS"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.