Individual provider Active NPI

James A Meagher, D.D.S

  • General Practice Dentistry
  • Peoria, IL
National Provider Identifier
1174545974
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19014628 Issued in IL
Practice address
6926 N University St Ste C
Peoria, IL 61614-1728
Phone
(309) 692-5863
Fax
(309) 689-3031
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 19014628 IL Primary

Addresses

Primary practice location

6926 N University St Ste C
Peoria, IL 61614-1728

Mailing address

6926 N University St Ste C
Peoria, IL 61614-1728
Phone (309) 692-5863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19014628ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Edward L Rick DDS,Ms,PC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174545974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6926 N UNIVERSITY ST STE C",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141728",
            "telephone_number": "309-692-5863",
            "fax_number": "309-689-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6926 N UNIVERSITY ST STE C",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141728",
            "telephone_number": "309-692-5863",
            "fax_number": "309-689-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEAGHER",
        "first_name": "JAMES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19014628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.