Individual provider Active NPI

Justin David Parker, MD

  • Family Medicine Physician
  • Decatur, IL
National Provider Identifier
1730490111
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
125057767 Issued in IL
Practice address
250 W Kenwood Ave
Decatur, IL 62526-4371
Phone
(217) 872-3800
Fax
(217) 872-0849
NPI assigned
Jun 30, 2010
Last updated
Jul 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01096764A IN
Family Medicine Physician 207Q00000X 125057767 IL Primary

Addresses

Primary practice location

250 W Kenwood Ave
Decatur, IL 62526-4371

Mailing address

250 W Kenwood Ave
Decatur, IL 62526-4371
Phone (217) 872-3800

Other practice location 1

5177 McCarty Ln
Lafayette, IN 47905-8764
Phone (765) 448-8000

Other identifiers 1

IdentifierTypeStateIssuer
036132477MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address justinparker@siusm.allscriptsdirect.net
Direct Messaging Address jparker@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130625000187 IL Practitioner - Family Practice 4688813595 Reassigns benefits to 2 organizations
I20250728003363 IN Practitioner - Family Practice 4688813595 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
Arnett Clinic LLCGroup PAC ID 0749184380, 401 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

5177 McCarty LN
Lafayette, IN 47905-8764
Phone (765) 448-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125057767ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Apr 23, 2013 Accepting new patients
Arnett Clinic, LLC Family Medicine CurrentSince Aug 25, 2025 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 7, 2026 Accepting new patients
Board of Trustees of Southern Illinois University Family Medicine CurrentSince Aug 22, 2017 Accepting new patients
Siu Physicians & Surgeons, Inc Family Medicine CurrentSince Apr 23, 2013 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Aug 22, 2017 Accepting new patients
Arnett Clinic, LLC CurrentSince Aug 25, 2025 Accepting new patients
Arnett Clinic, LLC Current Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

250 W Kenwood Ave
Decatur, IL 62526
Phone (217) 872-3800

520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

2600 Greenbush St
Lafayette, IN 47904

5177 McCarty Ln
Lafayette, IN 47905
Phone (765) 838-7101

Interoperability endpoints

  • Direct secure messaging: jparker@direct.iuhealth.org

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1730490111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W KENWOOD AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264371",
            "telephone_number": "217-872-3800",
            "fax_number": "217-872-0849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W KENWOOD AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264371",
            "telephone_number": "217-872-3800",
            "fax_number": "217-872-0849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5177 McCarty Ln",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479058764",
            "country_code": "US",
            "telephone_number": "765-448-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "JUSTIN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01096764A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125057767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036132477",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "justinparker@siusm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "250 W Kenwood Ave",
            "city": "Decatur",
            "state": "IL",
            "country_code": "US",
            "postal_code": "625264371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jparker@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5177 McCarty Ln",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479058764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.