Jason Foreman, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

021002580 Issued in IL

Practice address

2916 Crossing CT
Suite #C
Champaign, IL 61822-6199

Phone

(217) 352-5809

Fax

(217) 352-5812

NPI assigned

Jun 12, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1124432638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2916 CROSSING CT",
            "address_2": "SUITE #C",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618226199",
            "telephone_number": "217-352-5809",
            "fax_number": "217-352-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2916 CROSSING CT",
            "address_2": "SUITE #C",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618226199",
            "telephone_number": "217-352-5809",
            "fax_number": "217-352-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOREMAN",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029690",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "021002580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily M Foertsch, NP
• Jessica L Foley
• Stian Follestad, RBT
• Sandra Foltz
• Caitlyn Annice Foote, M.D.
• Forever Strong
• Nancy Lee Forsythe, LMHC
• Jurhee Forth
• Dajza Foster, RBT
• Dionne C Foster, LSW

• Endodontics in Champaign, IL
• Providers in Champaign, IL by specialty
• Endodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.