Active NPI
David A Hirstius, DO
- Family Medicine Physician
- Quincy, IL
National Provider Identifier
1780747170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036112783
- Practice address
- 1707 N 12TH St
Quincy, IL 62301 - Phone
- (217) 222-8641
- Fax
- (217) 222-8578
- NPI assigned
- Dec 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036112783 | IL | Primary |
| General Practice Physician | 208D00000X | 036112783 | IL |
Addresses
Primary practice location
1707 N 12TH St
Quincy, IL 62301
Mailing address
1707 N 12TH St
BLDG 29M
Quincy, IL 62301
Phone (217) 222-9487
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00211188 | Other | RAIL ROAD MEDICARE |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036112783 | IL | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260144000000",
"number": "1780747170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1707 N 12TH ST",
"address_2": "BLDG 29M",
"city": "QUINCY",
"state": "IL",
"postal_code": "62301",
"telephone_number": "217-222-9487",
"fax_number": "217-222-8578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1707 N 12TH ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "62301",
"telephone_number": "217-222-8641",
"fax_number": "217-222-8578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIRSTIUS",
"first_name": "DAVID",
"middle_name": "A",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2009-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036112783",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "IL",
"license": "036112783",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD MEDICARE",
"identifier": "P00211188",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Quincy, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.