NPIMap

Organization Active NPI

Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Belleville, IL
National Provider Identifier
1992082689
Registry record updated Oct 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CEPAMERICA ILLINOIS LLP
Practice address
4500 Memorial Dr
Belleville, IL 62226-5360
Phone
(618) 233-7750
NPI assigned
Nov 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2013

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

Authorized official

Name
Theophile Koury, MD
Title
VP
Phone
(510) 350-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

4500 Memorial Dr
Belleville, IL 62226-5360

Mailing address

2100 Powell St
Ste 900
Emeryville, CA 94608-1826
Phone (510) 350-2600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120322000587 IL Part B Supplier - Clinic/Group Practice 3274793633 Receives reassigned benefits from 1,241 practitioners
35 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Elk Grove Village, IL; Evanston, IL; Greenville, IL; Highland, IL; Hoffman Estates, IL; Joliet, IL; Kankakee, IL; Libertyville, IL…

Other NPIs on the same Medicare enrollment 35

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

View all 35

National Provider Directory

National Provider Directory

Locations

200 Health Care Dr
Greenville, IL 62246
Phone (618) 664-0808

Practitioners & affiliated clinicians

Practitioners 5

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": "1320710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381795200000",
    "number": "1992082689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "STE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "telephone_number": "618-233-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEPAMERICA ILLINOIS LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-08",
        "last_updated": "2013-10-15",
        "status": "A",
        "authorized_official_last_name": "KOURY",
        "authorized_official_first_name": "THEOPHILE",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "510-350-2600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.