Active NPI
Michael M. Bell Sr., DO
- Adult Medicine Physician
- Decature, IL
National Provider Identifier
1679633143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- 036.060478
- Practice address
- 2905 N. Main Street
Decature, IL 62526-4274 - Phone
- (217) 877-9117
- Fax
- (217) 877-3078
- NPI assigned
- Dec 12, 2006
- Last updated
- Jun 27, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2006-0962 | NC | |
| Adult Medicine Physician | 207QA0505X | 036.060478 | IL | Primary |
Addresses
Primary practice location
2905 N. Main Street
Decature, IL 62526-4274
Mailing address
2905 N. Main Street
Decatur, IL 62526-4274
Phone (217) 877-9117
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036.060478 | Medicaid | IL |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006-0962 | NC | MD | Family Medicine Physician |
| 036.060478 | IL | MD | Adult Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340755200000",
"number": "1679633143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2905 N. MAIN STREET",
"city": "DECATUR",
"state": "IL",
"postal_code": "625264274",
"telephone_number": "217-877-9117",
"fax_number": "217-877-3082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2905 N. MAIN STREET",
"city": "DECATURE",
"state": "IL",
"postal_code": "625264274",
"telephone_number": "217-877-9117",
"fax_number": "217-877-3078"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELL",
"first_name": "MICHAEL",
"middle_name": "M.",
"name_prefix": "Dr.",
"name_suffix": "Sr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2012-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "2006-0962",
"primary": false
},
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "IL",
"license": "036.060478",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036.060478",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.