John C. Kefalas, M.D.,S.C.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

36-094691 Issued in IL

Legal business name

JOHN C. KEFALAS, M.D.,S.C.

Doing business as

Central Illinois Bone and Joint Center

Practice address

2905 N Main St
Suite G
Decatur, IL 62526-4276

Phone

(217) 425-2600

Fax

(217) 425-2900

NPI assigned

Jun 28, 2005

Organization subpart

No

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

Authorized official

Name

Dr. John Chris Kefalas, M.D.NPI 1386832855

Title

President

Phone

(217) 425-2600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Central Illinois Bone and Joint Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• John Chris Kefalas, M.D.

  • Orthopaedic Surgery Physician
  • Decatur, IL
  • NPI 1386832855

  O20100930005770

  Same enrollment

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Decatur Open MRI, Inc.

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Decatur, IL
  • NPI 1508315086

  Member Of

  NPD member

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Chris Kefalas, M.D.

  • Orthopaedic Surgery Physician
  • Decatur, IL
  • NPI 1386832855
  Medicare reassignment Care Compare group NPD Authorized official
• Quinlan Syfert, PT

  • Physical Therapist
  • Decatur, IL
  • NPI 1720580467
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1811993405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 N MAIN ST",
            "address_2": "SUITE G",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264276",
            "telephone_number": "217-425-2600",
            "fax_number": "217-425-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 N MAIN ST",
            "address_2": "SUITE G",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264276",
            "telephone_number": "217-425-2600",
            "fax_number": "217-425-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C. KEFALAS, M.D.,S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-28",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "KEFALAS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CHRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-425-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "36-094691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36-094691",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Illinois Bone and Joint Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Orthopaedic Surgery Physician in Decatur, IL
• Providers in Decatur, IL by specialty
• Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.