Individual provider Active NPI

James T Brown, M.D.

  • Emergency Medicine Physician
  • Peoria, IL
National Provider Identifier
1699704122
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036-093389 Issued in IL
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone
(309) 655-2553
Fax
(309) 655-2602
NPI assigned
Jun 30, 2006
Last updated
Mar 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036-093389 IL Primary

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Mailing address

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 655-2000

Other identifiers 2

IdentifierTypeStateIssuer
800810OtherMEDICARE GROUP NO.
036093389MedicaidIL

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050725000835 IL Practitioner - Emergency Medicine 2668409368 Reassigns benefits to 17 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epss LLC - East SeriesGroup PAC ID 8729213459, 11 clinicians
Mason Hospital DistrictGroup PAC ID 2466360607, 41 clinicians

Practice addresses (Care Compare)

422 W White St
Clinton, IL 61727-2272
Phone (217) 935-9571

615 N Promenade St
Havana, IL 62644-1243
Phone (309) 543-8510

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-093389ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McDonough County Hospital District Emergency Medicine CurrentSince Aug 15, 2011 Accepting new patients
Epss, LLC- Metro Series Emergency Medicine CurrentSince Dec 15, 2021 Accepting new patients
Carle Health Medical Group Emergency Medicine CurrentSince Jan 1, 2026 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Dec 1, 2024 Accepting new patients
Mendota Community Hospital CurrentSince May 24, 2017 Accepting new patients
McDonough County Hospital District CurrentSince Aug 15, 2011 Accepting new patients
Pekin Memorial Hospital CurrentSince Jun 1, 2015 Accepting new patients
Pekin Memorial Hospital CurrentSince Jun 1, 2015 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Dec 2, 2024 Accepting new patients
City of Clinton CurrentSince Oct 17, 2023 Accepting new patients
Rochelle Community Hospital Association CurrentSince Oct 1, 2024 Accepting new patients
McDonough County Hospital District Current Accepting new patients
Mendota Community Hospital Current Accepting new patients
Mendota Community Hospital Emergency Medicine CurrentSince May 24, 2017 Accepting new patients
Epss LLC - Central Series Emergency Medicine CurrentSince Oct 1, 2017 Accepting new patients
Rochelle Community Hospital Association Emergency Medicine Current Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
Mason Hospital District CurrentSince Nov 7, 2010 Accepting new patients
McDonough County Hospital District Current Accepting new patients
Rochelle Community Hospital Association CurrentSince Oct 1, 2024 Accepting new patients
Epss Peoria LLC Emergency Medicine CurrentSince Jul 15, 2010 Accepting new patients
Epss LLC- Lakeside Series Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
McDonough County Hospital District Current Accepting new patients
Osf Healthcare System Current Accepting new patients
City of Clinton CurrentSince Oct 17, 2023 Accepting new patients
Mason Hospital District CurrentSince Nov 7, 2010 Accepting new patients
K M B S C Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Sep 1, 2021 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients

Locations

422 W White St
Clinton, IL 61727
Phone (217) 935-9570

615 N Promenade St
Havana, IL 62644
Phone (309) 543-8510

525 E Grant St
Macomb, IL 61455
Phone (309) 836-1611

1401 E 12th St
Mendota, IL 61342
Phone (815) 539-7461

1404 Washington St
Mendota, IL 61342
Phone (815) 538-1825

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

5409 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-1000

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828

900 N 2nd St
Rochelle, IL 61068
Phone (815) 562-2181

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9c9d3cdf-0f7f-4b63-979a-f711747b3e95/

Organizations & group practices 33

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.

View all 33

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1699704122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-2000",
            "fax_number": "309-655-7869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-2553",
            "fax_number": "309-655-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JAMES",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-093389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NO.",
            "identifier": "800810",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093389",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.