DR. JEFFREY R. CANHAM (NPI# 1770582983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770582983 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY R. CANHAM |
| Credential | M.D. |
| Practice Address |
302 W Hay St Suite 200 Decatur IL 62526-4167 |
| Mailing Address |
4431 Country Manor Ct Decatur IL 62521-2520 |
| Practice Telephone | 2178778925 |
| Practice Fax Number | 2178770020 |
| Mailing Telephone | 2174228300 |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2014-08-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 036-060206 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036060206 | 05 |
| Street Address |
302 W HAY ST SUITE 200 |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-4167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063411304 | Lee G Endsley | Urology | 302 W Hay St, Ste 200, Decatur, IL 62526-4167 | 2005-07-19 |
| 1073969044 | Nicole Suzette Soper | Registered Nurse | 302 W Hay St, Decatur, IL 62526-4167 | 2016-05-10 |
| 1629490628 | John W. Newlin, M.d., LLC | Internal Medicine | 302 W Hay St, Suite 130, Decatur, IL 62526-4167 | 2014-01-09 |
| 1811322001 | Sneha Kumar | Family Medicine | 302 W Hay St, Suite 110, Decatur, IL 62526-4167 | 2013-09-06 |
| 1104196294 | Jeremy Good | Physician Assistant | 302 W Hay St, Suite 200, Decatur, IL 62526-4167 | 2012-01-05 |
| 1255587176 | Midwest Neurology Associates, S.c. | Specialist | 302 W Hay St, Suite Ll110, Decatur, IL 62526-4167 | 2008-08-12 |
| 1699962209 | Steven E Weber, Md, Ltd | Surgery | 302 W Hay St, Suite 205, Decatur, IL 62526-4167 | 2007-09-27 |
| 1376737346 | Sudhakar Konda | Family Medicine | 302 W Hay St, Lower Level Suite 110, Decatur, IL 62526-6304 | 2007-08-31 |
| 1942333067 | Midwest Neurology Associates, S.c. | Specialist | 302 W Hay St, Suite Ll110, Decatur, IL 62526-4167 | 2007-03-14 |
| 1326191503 | Allen Bernard Devleschoward Jr. | Specialist | 302 W Hay St, Ste 210, Decatur, IL 62526-4167 | 2007-01-19 |
| 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 | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932451093 | Samuel Britt Owens | Urology | 2320 Brookwood Dr Se, Decatur, AL 35601-6176 | 2012-10-12 |
| 1245505536 | Urology Associates of North Alabama | Urology | 1874 Beltine Road, Sw, Suite 106, Decatur, AL 35601 | 2012-03-20 |
| 1912183443 | Syed Mohammad Akbar Jafri | Urology | 3002 Mount Olive Dr, Decatur, GA 30033-3016 | 2008-01-15 |
| 1114138104 | Alabama Urology and Robotics Center | Urology | 1210 14th Avenue South East, Decatur, AL 35601 | 2007-05-24 |
| 1518903988 | Karl L Pete | Urology | 2711 Irvin Way Ste 102, Decatur, GA 30030 | 2006-06-22 |
| 1053366641 | William E Hughes | Urology | 1210 14th Ave Se, Suite G200, Decatur, AL 35601 | 2006-05-23 |
| 1992761712 | Russell Gene Doubrava | Urology | 2451 S Fm 51, Suite 100, Decatur, TX 76234 | 2006-04-21 |
| 1639135452 | Russell Doubrava Do Pa | Urology | 2010 Ben Merritt Dr, Ste B, Decatur, TX 76234 | 2006-04-21 |
| 1063411304 | Lee G Endsley | Urology | 302 W Hay St, Ste 200, Decatur, IL 62526-4167 | 2005-07-19 |
| 1871144246 | Georgia Urology Pa | Urology | 1670 Scott Blvd Ste 204k, Decatur, GA 30033-5645 | 2019-09-26 |
| 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.