NPIMap

Individual provider Active NPI

Glen N Feather, DO

  • Pain Medicine (Anesthesiology) Physician
  • Canton, IL
National Provider Identifier
1962492900
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
036079920 Issued in IL
Practice address
180 S Main St
Canton, IL 61520-2608
Phone
(309) 647-0201
Fax
(309) 649-6880
NPI assigned
Oct 21, 2005
Last updated
Nov 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036079920 IL
Pain Medicine (Anesthesiology) Physician 207LP2900X 036079920 IL Primary

Addresses

Primary practice location

180 S Main St
Canton, IL 61520-2608

Mailing address

2907 W Wardcliffe Dr
Peoria, IL 61604-2157
Phone (309) 404-1914

Other practice location 1

1024 N Magnolia St
Elmwood, IL 61529-9602
Phone (309) 742-6334

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
I20051202000728 IL Practitioner - Pain ManagementPractitioner - AnesthesiologyPractitioner - Physical Medicine and Rehabilitation 6204856339 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Midwestern University, Chicago College of Osteopathic Med, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graham Hospital AssociationGroup PAC ID 2769375021, shared by 15 NPIs, 124 clinicians
Mason Hospital DistrictGroup PAC ID 2466360607, shared by 5 NPIs, 41 clinicians

Practice addresses (Care Compare)

180 S Main St
Canton, IL 61520-2608
Phone (309) 647-0201

2028 N Seminary St
Galesburg, IL 61401-4559
Phone (309) 647-0201

210 W Walnut St
Canton, IL 61520-2444
Phone (309) 647-5240

615 N Promenade St
Havana, IL 62644-1243
Phone (309) 543-8510

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
83.26 of 100Reported as group
Quality
62.57
Promoting interoperability
100
Improvement activities
40
Cost
77.37

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mason Hospital District CurrentSince Mar 5, 2024 Accepting new patients
Mason Hospital District CurrentSince Mar 5, 2024 Accepting new patients
Graham Hospital Association CurrentSince Jan 1, 2013 Accepting new patients
Graham Hospital Association Current Accepting new patients
Graham Hospital Association Family Medicine CurrentSince Jan 1, 2013 Accepting new patients
Mason Hospital District Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Associated Anesthesiologists, S.C. Anesthesiology Past Accepting new patients
Southwest Pain & Spine Center LLC Past Accepting new patients

Locations

175 S Main St
Canton, IL 61520
Phone (309) 647-3937

180 S Main St
Canton, IL 61520
Phone (309) 647-5240

1024 N Magnolia St
Elmwood, IL 61529
Phone (309) 742-6334

615 N Promenade St
Havana, IL 62644
Phone (309) 543-6600

Organizations & group practices 9

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 3

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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1962492900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 W WARDCLIFFE DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616042157",
            "telephone_number": "309-404-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 S MAIN ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202608",
            "telephone_number": "309-647-0201",
            "fax_number": "309-649-6880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1024 N Magnolia St",
            "address_purpose": "LOCATION",
            "city": "Elmwood",
            "state": "IL",
            "postal_code": "615299602",
            "country_code": "US",
            "telephone_number": "309-742-6334",
            "fax_number": "309-649-6880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEATHER",
        "first_name": "GLEN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036079920",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036079920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, IL

Sources for this page

Verify at the official NPI Registry.