Decatur Psychiatry LTD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036105848 Issued in IL

Legal business name

DECATUR PSYCHIATRY LTD

Practice address

2580 E Federal Dr Ste 403
Decatur, IL 62526-2189

Phone

(217) 809-0429

Fax

(217) 422-0041

NPI assigned

Jan 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Anjum Bashir, M.D.NPI 1568440683

Title

Owner

Phone

(217) 809-0429

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anjum Bashir, M.D.

  • Psychiatry Physician
  • Decatur, IL
  • NPI 1568440683
  Medicare reassignment Care Compare group Authorized official
• Amanda Fisher, LCSW

  • Clinical Social Worker
  • Decatur, IL
  • NPI 1942053616
  Medicare reassignment Care Compare group NPD
• Beverly J Matthews, PSYD

  • Psychologist
  • Springfield, IL
  • NPI 1558463760
  Medicare reassignment Care Compare group NPD
• Annie Michele Smith, L.C.S.W.

  • Clinical Social Worker
  • Decatur, IL
  • NPI 1902340730
  Medicare reassignment Care Compare group
• Gloria Cabrera Eichenauer, MA, LCPC

  • Professional Counselor
  • Decatur, IL
  • NPI 1598834160
  NPD (past)
• Michael Lee Krumtinger, LCPC

  • Mental Health Counselor
  • Decatur, IL
  • NPI 1255491114
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1770638686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 E FEDERAL DR STE 403",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625262189",
            "telephone_number": "217-809-0429",
            "fax_number": "217-422-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 E FEDERAL DR STE 403",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625262189",
            "telephone_number": "217-809-0429",
            "fax_number": "217-422-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR PSYCHIATRY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "BASHIR",
        "authorized_official_first_name": "ANJUM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-809-0429",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036105848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105848",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "213272",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Decatur Neurological Associates LTD.
• Decatur OBGYN Associates, LLC
• Decatur Open MRI, Inc.
• Decatur Pediatric Clinic
• Decatur Pharmacyxpress LLC
• Decatur Psychological Associates PC
• Decatur Public School Dist. #61
• Decatur Radiology Physicians Services PLLC
• David Deeb, LPC
• Martha Deetz

• Psychiatry Physician in Decatur, IL
• Providers in Decatur, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.