David D Coultas, M.D. – Internal Medicine Physician

Key facts

NPI: 1902804495
Entity type: Individual (NPI type 1)
Primary specialty: Internal Medicine Physician 207R00000X
Practice address: 1606 W Lafayette Ave
Jacksonville, IL 62650-3707
Phone: (217) 245-1421
Fax: (217) 243-1699
NPI assigned: Jul 8, 2005
Sex: Male
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Gibson Community Hospital Association Critical Access Hospital · Gibson City, IL · NPI 1114935681

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

Practice roles

Organization	Specialty	Status	New patients
Gibson Community Hospital Association		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Internal Medicine Physician	207R00000X		IL	Yes

Addresses

Primary practice location

1606 W Lafayette Ave
Jacksonville, IL 62650-3707

Mailing address

PO Box 3428
Springfield, IL 62708-3428
Phone (217) 757-7491

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 13, 2026.

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1902804495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3428",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627083428",
            "telephone_number": "217-757-7491",
            "fax_number": "217-757-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 W LAFAYETTE AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503707",
            "telephone_number": "217-245-1421",
            "fax_number": "217-243-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTAS",
        "first_name": "DAVID",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, IL

All providers in Jacksonville, IL · Internal Medicine Physician in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.