NPIMap

Organization Active NPI

Decatur Orthopedic Center, LLC

  • Non-Pharmacy Dispensing Site
  • Mt Zion, IL
National Provider Identifier
1720736002
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
DECATUR ORTHOPEDIC CENTER, LLC
Practice address
104 E Ashland Ave
Mt Zion, IL 62549-1271
Phone
(217) 864-2665
NPI assigned
Mar 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Authorized official

Name
Kristin E Sams
Title
Finance Director
Phone
(217) 864-2665

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

104 E Ashland Ave
Mt Zion, IL 62549-1271

Mailing address

104 E Ashland Ave
Mt Zion, IL 62549-1271
Phone (217) 864-2665

National Provider Directory

National Provider Directory
Tax ID family
Decatur Orthopedic Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

104 E Ashland Ave
Mt Zion, IL 62549
Phone (217) 864-2665

NPI Registry JSON

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1720736002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E ASHLAND AVE",
            "city": "MT ZION",
            "state": "IL",
            "postal_code": "625491271",
            "telephone_number": "217-864-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E ASHLAND AVE",
            "city": "MT ZION",
            "state": "IL",
            "postal_code": "625491271",
            "telephone_number": "217-864-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR ORTHOPEDIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "SAMS",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "217-864-2665"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Zion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.