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
Sex
Male
Sole proprietor
Yes

Organizations & group practices 24

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.

View all 24

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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 Association 124 clinicians
Mason Hospital District 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

  • Graham Hospital Association Hospital, Canton, IL, CCN 141356
  • Graham Hospital Association Hospital, Canton, IL, CCN 140001
  • Mason District Hospital Hospital, Havana, IL, CCN 141313
  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
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

National Provider Directory

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

Practice roles

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

Locations

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

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

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

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

Specialties & licenses 2

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

Addresses

NPPES NPI Registry

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

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
036079920MedicaidIL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 18, 2019.

{
    "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036079920",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, IL

Sources for this page

Verify at the official NPI Registry.