Rebecca Kathleen Bumgardner, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4455 E US Route 36
Decatur, IL 62521-5003

Phone

(217) 876-5320

Fax

(217) 876-5865

NPI assigned

May 19, 2023

Last updated

Sep 8, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Rebecca K Miller Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Physician ServicesGroup PAC ID 9032005681, 161 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Decatur Memorial Hospital Hospital, Decatur, IL, CCN 140135

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Memorial Physician Services

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1174877930

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Family Medical Center of Chatham, LLC

  • Family Medicine Physician
  • Chatham, IL
  • NPI 1992956528
  NPD
• Memorial Physician Services

  • Rural Health Clinic/Center
  • Jacksonville, IL
  • NPI 1528741147
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1548357973
  Care Compare affiliation

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1669164596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 E US ROUTE 36",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625215003",
            "telephone_number": "217-876-5320",
            "fax_number": "217-876-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 E US ROUTE 36",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625215003",
            "telephone_number": "217-876-5320",
            "fax_number": "217-876-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUMGARDNER",
        "first_name": "REBECCA",
        "middle_name": "KATHLEEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-19",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "MILLER",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Yvonne Brummet, PTA
• Byrle Brunton, NP
• Marshall F Brustein, MD
• Joseph P Bulinski, PA-C
• Evan Bullock
• Vicki Jo Burke, MS CCC L
• Pamela Starr Burkhart, LCSW
• Chad Martin Burmeister, DMD
• Kelsie Burner, PHARM. D.
• Melissa Ann Burnett, DMD

• Physician Assistant in Decatur, IL
• Providers in Decatur, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.