Individual provider Active NPI

Frank L Mikell, M.D.

  • Specialist
  • Springfield, IL
National Provider Identifier
1669582904
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036064044 Issued in IL
Practice address
619 E Mason St
Suite 4P57
Springfield, IL 62701-1034
Phone
(217) 788-0706
Fax
(217) 788-0848
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036064044 IL Primary

Addresses

Primary practice location

619 E Mason St
Suite 4P57
Springfield, IL 62701-1034

Mailing address

PO Box 19420
Springfield, IL 62794-9420
Phone (217) 788-0706

Other identifiers 2

IdentifierTypeStateIssuer
036064044OtherILRAILROAD
036064044MedicaidIL

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie Cardiovascular Consultants LTD Past Accepting new patients
Prairie Diagnostic Center, LLC PastSince Oct 3, 2006 Accepting new patients
Prairie Cardiovascular Consultants LTD Specialist Past Accepting new patients

Organizations & group practices 3

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1669582904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19420",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949420",
            "telephone_number": "217-788-0706",
            "fax_number": "217-788-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 E MASON ST",
            "address_2": "SUITE 4P57",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011034",
            "telephone_number": "217-788-0706",
            "fax_number": "217-788-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKELL",
        "first_name": "FRANK",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036064044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "036064044",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036064044",
            "state": "IL"
        }
    ],
    "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 Jun 2, 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.