THE SPORTS & PHYSICAL MEDICINE CLINIC @ ST. MARY'S
NPI 1174702708
Physician Assistant in Decatur, IL
NPI Status: Active since October 31, 2007
Contact Information
1900 E LAKE SHORE DR
SUITE 200
DECATUR, IL
ZIP 62521
Phone: (217) 464-1030
Fax: (217) 464-1039
- Organization
- Physician Assistant
About THE SPORTS & PHYSICAL MEDICINE CLINIC @ ST. MARY'S
This page provides the complete NPI Profile along with additional information for The Sports & Physical Medicine Clinic @ St. Mary's, a primary care provider established in Decatur, Illinois operating as a Physician Assistant. The healthcare provider is registered in the NPI registry with number 1174702708 assigned on October 2007. The practitioner's primary taxonomy code is 363A00000X with license number 085-003034 (IL). The provider is registered as an organization and their NPI record was last updated 2 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as The Sports & Physical Medicine Clinic @ St. Mary's. The authorized official of this NPI record is Mark D Evard (Vp Of Revenue Cycle)
- NPI
- 1174702708
- Provider Legal Name
- ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER
- Other Organization Name
- THE SPORTS & PHYSICAL MEDICINE CLINIC @ ST. MARY'S
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1900 E LAKE SHORE DR SUITE 200 DECATUR, IL 62521
- Location Phone
- (217) 464-1030
- Location Fax
- (217) 464-1039
- Mailing Address
- 3051 HOLLIS DR SPRINGFIELD, IL 62704
- Mailing Phone
- (217) 464-2966
- Mailing Fax
- (217) 464-1039
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-31-2007
- Last Update Date
- 10-31-2024
- Code Navigator
A primary care provider (PCP) like The Sports & Physical Medicine Clinic @ St. Mary's sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 085-003034
- License State
- IL
- Taxonomy Description
- A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1174702708, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 52 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 15 providers are registered at the same or a nearby location.
DECATUR, IL 62521
DECATUR, IL 62521
DECATUR, IL 62521
DECATUR, IL 62521
DECATUR, IL 62521
DECATUR, IL 62521
DECATUR, IL 62521
DECATUR, IL 62521
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174702708, enumerated as an "organization" on October 31, 2007.
The provider is located at 1900 E LAKE SHORE DR SUITE 200 DECATUR, IL 62521 and the phone number is (217) 464-1030.
Physician Assistant with taxonomy code 363A00000X.
