NPIMap

Individual provider Active NPI

Edward Price Odell Harter, MD

  • Diagnostic Radiology Physician
  • Springfield, IL
National Provider Identifier
1841452463
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036135492 Issued in IL
Practice address
1025 S 6TH St
Springfield, IL 62703-2499
Phone
(217) 528-7541
NPI assigned
Jun 25, 2008
Last updated
Aug 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2014026431 MO
Diagnostic Radiology Physician 2085R0202X 036135492 IL Primary

Addresses

Primary practice location

1025 S 6TH St
Springfield, IL 62703-2499

Mailing address

PO Box 19248
Springfield, IL 62794-9248
Phone (217) 528-7541

Other identifiers 1

IdentifierTypeStateIssuer
036135492MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140811001842 IL Practitioner - Diagnostic Radiology 8426275744 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Southern Illinois University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Medical CenterGroup PAC ID 7315835949, 131 clinicians
Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians

Practice addresses (Care Compare)

701 N 1St St
Springfield, IL 62781-0001
Phone (800) 577-5368

800 N 1St St
Springfield, IL 62702-3719
Phone (217) 528-7541

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014026431MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Medical Center CurrentSince May 1, 2021 Accepting new patients
Springfield Clinic LLP Current Accepting new patients
Memorial Medical Center CurrentSince May 1, 2021 Accepting new patients
Springfield Clinic, LLP CurrentSince Sep 5, 2014 Accepting new patients
Crawford Hospital District Current Accepting new patients

Locations

1000 N Allen St
Robinson, IL 62454
Phone (618) 544-3131

1025 S 6th St
Springfield, IL 62703

701 N 1st St
Springfield, IL 62781
Phone (217) 788-3100

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

800 N 1st St
Springfield, IL 62702

Interoperability endpoints

  • Direct secure messaging: edward.harter.1@28977.direct.athenahealth.com
  • Direct secure messaging: edwardharter@sfc.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Springfield Clinic Lincoln Rural HealthLincoln, IL, CCN 143925 Rural health clinic Limited Partnership Interest Jul 1, 2021
Springfield Clinic Nokomis Rural HealthNokomis, IL, CCN 783814 Rural health clinic Limited Partnership Interest Jul 1, 2021
Springfield Clinic Raymond Rural HealthRaymond, IL, CCN 783829 Rural health clinic Limited Partnership Interest Jul 1, 2021
Springfield Clinic Neoga Rural HealthNeoga, IL, CCN 783812 Rural health clinic Limited Partnership Interest Jul 1, 2021
Springfield Clinic, LLPMacomb, IL, CCN 783855 Rural health clinic Limited Partnership Interest Jul 1, 2021

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 5

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": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1841452463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19248",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949248",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032499",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTER",
        "first_name": "EDWARD",
        "middle_name": "PRICE ODELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2014026431",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036135492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036135492",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.