NPIMap

Organization Active NPI

McDonough County Hospital District

  • Otolaryngology Physician
  • Macomb, IL
National Provider Identifier
1881032985
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
0001438 Issued in IL
Legal business name
MCDONOUGH COUNTY HOSPITAL DISTRICT
Practice address
515 E Grant St
Macomb, IL 61455-3368
Phone
(309) 833-6937
NPI assigned
Jun 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Authorized official

Name
Kenny Boyd Jr.
Title
Ceo
Phone
(309) 833-4101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 0001438 IL Primary

Addresses

Primary practice location

515 E Grant St
Macomb, IL 61455-3368

Mailing address

515 E Grant St
Macomb, IL 61455-3368
Phone (309) 833-6937

Other names 1

  • MDH Ear Nose and Throat Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090407000082 IL Part B Supplier - Clinic/Group Practice 0446140180 Receives reassigned benefits from 78 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monmouth, IL; Macomb, IL; Carthage, IL

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370908800000",
    "number": "1881032985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 E GRANT ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614553368",
            "telephone_number": "309-833-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 E GRANT ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614553368",
            "telephone_number": "309-833-6937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCDONOUGH COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-11",
        "last_updated": "2013-06-11",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-833-4101",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "0001438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MDH Ear Nose and Throat",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macomb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.