JOHN C. KEFALAS, M.D.,S.C. (NPI# 1811993405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811993405 |
| Entity Type | Organization |
| Organization Name | JOHN C. KEFALAS, M.D.,S.C. |
| Other Organization Name | CENTRAL ILLINOIS BONE AND JOINT CENTER |
| Practice Address |
2905 N Main St Suite G Decatur IL 62526-4276 |
| Practice Telephone | 2174252600 |
| Practice Fax Number | 2174252900 |
| Mailing Telephone | 2174252600 |
| Mailing Fax Number | 2174252900 |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2017-02-13 |
| Authorized Official Name | DR. JOHN CHRIS KEFALAS (PRESIDENT) |
| Authorized Official Telephone | 2174252600 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 36-094691 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 36-094691 | 05 |
| Other Name | Type Code |
|---|---|
| Central Illinois Bone and Joint Center | Doing Business As Name - Organization |
| Street Address |
2905 N MAIN ST SUITE G |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-4276 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508315086 | Decatur Open Mri, Inc. | Clinic/Center | 2905 N Main St, Suite F, Decatur, IL 62526-4276 | 2016-09-26 |
| 1528434222 | Angela L King | Nurse Practitioner | 2905 N Main St, Decatur, IL 62526-4274 | 2015-08-17 |
| 1821407818 | Brentny Renfro | Physician Assistant | 2905 N Main St, Decatur, IL 62526-4274 | 2014-08-05 |
| 1073946141 | Gabrielle K. Sauder | Nurse Practitioner | 2905 N Main St, Decatur, IL 62526-4274 | 2013-08-13 |
| 1770836991 | Community Health Improvement Center | Social Worker | 2905 N Main St, Decatur, IL 62526-4274 | 2012-10-25 |
| 1528349834 | Jessica Ann Conlin | Nurse Practitioner | 2905 N Main St, Decatur, IL 62526-4274 | 2011-08-31 |
| 1285930578 | Amy E Marsili | Social Worker | 2905 N Main St, Decatur, IL 62526-4274 | 2011-02-03 |
| 1053620930 | Cami Jo Kistenfeger | Physician Assistant | 2905 N Main St, Ste. G, Decatur, IL 62526-4274 | 2010-09-27 |
| 1447568605 | Allison M Raiha | Dietitian, Registered | 2905 N Main St, Decatur, IL 62526-4274 | 2010-09-21 |
| 1518132877 | Manisha Ahuja | Internal Medicine | 2905 N Main St, Decatur, IL 62526-4274 | 2008-04-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780181370 | Ryan Patton | Orthopaedic Surgery | 2723 Hollywood Dr, Decatur, GA 30033 | 2018-04-10 |
| 1689964280 | Saif U Zaman | Orthopaedic Surgery | 505 Irvin Ct Ste 200, Decatur, GA 30030-1780 | 2011-04-15 |
| 1740485317 | Georgia Knee & Sports Medicine | Orthopaedic Surgery | 2801 N Decatur Road, Decatur, GA 30033-5949 | 2007-06-15 |
| 1063553741 | Sportsmed Orthopaedic Specialists, P.C. | Orthopaedic Surgery | 2506 Danville Rd Sw Ste 202, Decatur, AL 35603-4232 | 2007-02-08 |
| 1336109867 | Orthopaedics Northeast, PC | Orthopaedic Surgery | 805 High St, Decatur, IN 46733-2324 | 2006-03-27 |
| 1245205020 | Julio Petilon | Orthopaedic Surgery | 2801 N Decatur Rd Ste 200, Decatur, GA 30033 | 2006-02-23 |
| 1437130986 | Fitzgerald Orthopaedics, P.C. | Orthopaedic Surgery | 203 N 12th St, Decatur, IN 46733-1554 | 2005-11-10 |
| 1891782918 | Lawrence A. Bircoll | Orthopaedic Surgery | 487 Winn Way, Suite 100, Decatur, GA 30030-1735 | 2005-10-04 |
| 1073500401 | James B. Madeley | Orthopaedic Surgery | 2680 Lawrenceville Hwy, Suite 100, Decatur, GA 30033-2526 | 2005-09-30 |
| 1285638072 | M Stephen Huss | Orthopaedic Surgery | 304 W Hay St, Ste 213, Decatur, IL 62526-4169 | 2005-06-09 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.