John L Poag II, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036098050 Issued in IL

Practice address

1401 Eastland Dr
Bloomington, IL 61701-3514

Phone

(309) 663-8311

Fax

(309) 663-1810

NPI assigned

Dec 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bromenn Healthcare, Inc.

  • General Acute Care Hospital
  • Normal, IL
  • NPI 1184808404
  NPD (past)
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• Pekin Prohealth Inc

  • Family Medicine Physician
  • Pekin, IL
  • NPI 1932150299

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335225600000",
    "number": "1770569550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 EASTLAND DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013514",
            "telephone_number": "309-663-8311",
            "fax_number": "309-663-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 EASTLAND DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013514",
            "telephone_number": "309-663-8311",
            "fax_number": "309-663-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POAG",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2012-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036098050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098050",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5715384",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah S Pitcher, AUD
• Sam Pittmon, MD
• Planned Parenthood of Illinois
• Elizabeth K Plocher, M.D.
• Luke Ploessl
• Lucas C Pogue, M.D.
• Pointcore, Inc. (Eastland Pharmacy)
• Josephine Pollock
• Monica L Pollock
• Edward Lee Ponce, PT

• Internal Medicine Physician in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.