Individual provider Active NPI

Robert Douglas Dent, D.C.

  • Chiropractor
  • New Baden, IL
National Provider Identifier
1013913227
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-004870 Issued in IL
Practice address
701 E Hanover St
New Baden, IL 62265-1908
Phone
(618) 588-4976
Fax
(618) 588-4926
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-004870 IL Primary

Addresses

Primary practice location

701 E Hanover St
New Baden, IL 62265-1908

Mailing address

701 E Hanover St
New Baden, IL 62265-1908
Phone (618) 588-4976

Other identifiers 2

IdentifierTypeStateIssuer
1482002OtherILBCBS
038-004870MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101101000762 IL Practitioner - Chiropractic 4284828500 Practice locations: New Baden, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

701 E Hanover St
New Baden, IL 62265-1939
Phone (618) 588-4976

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pamela Rout DC Chiropractor Past Accepting new patients
R. Douglas Dent Chiropractor PastSince Jul 22, 1983 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1013913227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E HANOVER ST",
            "city": "NEW BADEN",
            "state": "IL",
            "postal_code": "622651908",
            "telephone_number": "618-588-4976",
            "fax_number": "618-588-4926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E HANOVER ST",
            "city": "NEW BADEN",
            "state": "IL",
            "postal_code": "622651908",
            "telephone_number": "618-588-4976",
            "fax_number": "618-588-4926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENT",
        "first_name": "ROBERT",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-004870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1482002",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038-004870",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Baden, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.