NPIMap

Organization Active NPI

Quincy Physicians & Surgeons Clinic, PLLC

  • Hematology & Oncology Physician
  • Quincy, IL
National Provider Identifier
1861986549
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
036094428 Issued in IL
Legal business name
QUINCY PHYSICIANS & SURGEONS CLINIC, PLLC
Practice address
3301 Broadway St
Quincy, IL 62301-3713
Phone
(217) 277-4070
NPI assigned
Jun 18, 2018
Last updated
Dec 20, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
QUINCY PHYSICIANS & SURGEONS CLINIC, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Authorized official

Name
Patty Woerman
Title
Credentialing Specialist
Phone
(217) 222-6550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 036094428 IL Primary

Addresses

Primary practice location

3301 Broadway St
Quincy, IL 62301-3713

Mailing address

1025 Maine St
Quincy, IL 62301-4038
Phone (217) 222-6550

Other names 1

  • Quincy Medical Group, Raymond Smith, MD Other name

National Provider Directory

National Provider Directory
Tax ID family
Quincy Med GRP Lewistow25 organizations share this tax ID, including this one
Part of
Quincy Med GRP Lewistow

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639958400000",
    "number": "1861986549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014038",
            "telephone_number": "217-222-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623013713",
            "telephone_number": "217-277-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUINCY PHYSICIANS & SURGEONS CLINIC, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUINCY PHYSICIANS & SURGEONS CLINIC, PLLC",
        "enumeration_date": "2018-06-18",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A",
        "authorized_official_last_name": "WOERMAN",
        "authorized_official_first_name": "PATTY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "217-222-6550"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036094428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quincy Medical Group, Raymond Smith, MD",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Quincy Medical Group, Raymond Smith, MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.