Active NPI
James William Farrell, M.D.
- Ophthalmology Physician
- Pekin, IL
National Provider Identifier
1700885175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 036078398
- Practice address
- 101 N Parkway Dr
Pekin, IL 61554-3932 - Phone
- (309) 347-5115
- Fax
- (309) 347-7036
- NPI assigned
- Jul 19, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 036078398 | IL | Primary |
Addresses
Primary practice location
101 N Parkway Dr
Pekin, IL 61554-3932
Mailing address
1008 N Main St
Bloomington, IL 61701-1784
Phone (800) 325-7706
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9000192 | Other | IL | BLUE CROSS BLUE SHIELD |
| 036078398 | 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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036078398 | IL | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Eye Care PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Durable Medical Equipment & Medical Supplies
- Pekin, IL
- NPI 1780786160
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363824000000",
"number": "1700885175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1008 N MAIN ST",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617011784",
"telephone_number": "800-325-7706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 N PARKWAY DR",
"city": "PEKIN",
"state": "IL",
"postal_code": "615543932",
"telephone_number": "309-347-5115",
"fax_number": "309-347-7036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARRELL",
"first_name": "JAMES",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-19",
"last_updated": "2013-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IL",
"license": "036078398",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "9000192",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036078398",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pekin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.