Individual provider Active NPI

Casey Rexroat

  • Basic Emergency Medical Technician
  • Monmouth, IL
National Provider Identifier
1104370493
Registry record updated Aug 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Basic Emergency Medical TechnicianTaxonomy code 146N00000X
License
001059393 Issued in IL
Practice address
601 Industrial Park Rd
Monmouth, IL 61462-9796
Phone
(309) 734-8428
NPI assigned
Aug 4, 2016
Last updated
Aug 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X 001059393 IL Primary

Addresses

Primary practice location

601 Industrial Park Rd
Monmouth, IL 61462-9796

Mailing address

1112 E Franklin Ave
Monmouth, IL 61462-1464

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
001059393ILMDBasic Emergency Medical Technician

Practice roles

OrganizationSpecialtyStatusNew patients
City of Monmouth Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1104370493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 E FRANKLIN AVE",
            "city": "MONMOUTH",
            "state": "IL",
            "postal_code": "614621464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 INDUSTRIAL PARK RD",
            "city": "MONMOUTH",
            "state": "IL",
            "postal_code": "614629796",
            "telephone_number": "309-734-8428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REXROAT",
        "first_name": "CASEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-04",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "IL",
            "license": "001059393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monmouth, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2016; 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.