Individual provider Active NPI

William N Baskin, M.D.

  • Gastroenterology Physician
  • Rockford, IL
National Provider Identifier
1063408342
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
36054658 Issued in IL
Practice address
401 Roxbury Rd
Rockford, IL 61107-5075
Phone
(815) 397-7340
Fax
(815) 397-2156
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 36054658 IL Primary
Gastroenterology Physician 207RG0100X 27434-020 WI

Addresses

Primary practice location

401 Roxbury Rd
Rockford, IL 61107-5075

Mailing address

401 Roxbury Rd
Rockford, IL 61107-5075
Phone (815) 397-7340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36054658ILMDGastroenterology Physician
27434-020WIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Gastroenterology Associates, LTD. Gastroenterology Current Accepting new patients
Rockford Gastroenterology Associates, LTD. Current Accepting new patients

Locations

401 Roxbury Rd
Rockford, IL 61107
Phone (815) 397-7340

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1063408342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075075",
            "telephone_number": "815-397-7340",
            "fax_number": "815-397-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075075",
            "telephone_number": "815-397-7340",
            "fax_number": "815-397-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASKIN",
        "first_name": "WILLIAM",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "36054658",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "27434-020",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.