Individual provider Active NPI

Richard Hayes, MD

  • Cardiovascular Disease Physician
  • Rockford, IL
National Provider Identifier
1932177136
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036-058797 Issued in IL
Practice address
2350 N Rockton Ave
Rockford, IL 61103-3600
Phone
(815) 971-2000
Fax
(815) 971-9097
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036-058797 IL Primary

Addresses

Primary practice location

2350 N Rockton Ave
Rockford, IL 61103-3600

Mailing address

2350 N Rockton Ave
Rockford, IL 61103-3600
Phone (815) 971-2000

Other identifiers 1

IdentifierTypeStateIssuer
036058797MedicaidIL

Medicare participation

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-058797ILMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Freeport Memorial Hospital Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1932177136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 N ROCKTON AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033600",
            "telephone_number": "815-971-2000",
            "fax_number": "815-971-9097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N ROCKTON AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033600",
            "telephone_number": "815-971-2000",
            "fax_number": "815-971-9097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036-058797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058797",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; 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.