Active NPI
Alyssa Higgins
- Dental Hygienist
- Bloomington, IL
National Provider Identifier
1124476148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 020.014749
- Practice address
- 1407 N Veterans Pkwy
Suite 12
Bloomington, IL 61704-6630 - Phone
- (309) 661-2999
- NPI assigned
- May 31, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 020.014749 | IL | Primary |
Addresses
Primary practice location
1407 N Veterans Pkwy
Suite 12
Bloomington, IL 61704-6630
Mailing address
901 Sheridan St
Chenoa, IL 61726-1442
Phone (309) 530-0683
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 46-1340371 | Medicaid | IL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 020.014749 | IL | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464652800000",
"number": "1124476148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 SHERIDAN ST",
"city": "CHENOA",
"state": "IL",
"postal_code": "617261442",
"telephone_number": "309-530-0683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1407 N VETERANS PKWY",
"address_2": "SUITE 12",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617046630",
"telephone_number": "309-661-2999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIGGINS",
"first_name": "ALYSSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-31",
"last_updated": "2016-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "IL",
"license": "020.014749",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "46-1340371",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.