Sophia E. W. Pelling

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036.139063 Issued in IL

Practice address

20201 Crawford Ave
Olympia Fields, IL 60461-1010

Phone

(630) 913-6621

NPI assigned

Mar 1, 2012

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

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Midwestern University, Chicago College of Osteopathic Med, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sandy Creek Emergency Group, PCGroup PAC ID 3577905520, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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 and National Provider Directory roles.

• Sandy Creek Emergency Group, PC

  • Emergency Medicine Physician
  • Fayetteville, GA
  • NPI 1427817881
  Medicare reassignment Care Compare group NPD

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

• Fayette Community Hospital, Inc.

  • General Acute Care Hospital
  • Fayetteville, GA
  • NPI 1528027240
  Care Compare affiliation

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448409600000",
    "number": "1669746178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20201 CRAWFORD AVE",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611010",
            "telephone_number": "630-913-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20201 CRAWFORD AVE",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611010",
            "telephone_number": "630-913-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLING",
        "first_name": "SOPHIA",
        "middle_name": "E. W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-01",
        "last_updated": "2015-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.139063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monika Paulauskaite, PTA
• William K Payne III, M.D.
• Peaceful Chaos PLLC
• Peacefully Adjacent Therapy & Wellness PLLC
• Renee Peart, MD
• Jasmine N Perkins, LCSW
• Tiana Monique Perry, BCBA
• Personal Growth Center, LTD.
• Jacob Peschke, DO
• Bernadette Phan, DO

• Emergency Medicine Physician in Olympia Fields, IL
• Providers in Olympia Fields, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; 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.