Individual provider Active NPI

Jennifer Michelle Rapini, DDS

  • General Practice Dentistry
  • Alton, IL
National Provider Identifier
1194030957
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19035149 Issued in IL
Practice address
2800 College Ave
Alton, IL 62002-4742
Phone
(580) 371-2343
Fax
(580) 371-3614
NPI assigned
Aug 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6454 OK
Dentist 122300000X 2010017952 MO
General Practice Dentistry 1223G0001X 19035149 IL Primary

Addresses

Primary practice location

2800 College Ave
Alton, IL 62002-4742

Mailing address

2800 College Ave
Alton, IL 62002-4742
Phone (580) 371-2343

Other practice location 1

606 E Buchanan St # Mo
California, MO 65018-1910
Phone (573) 632-2777

Other practice location 2

610 E 24th St
Tishomingo, OK 73460-3245
Phone (580) 371-2343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20231206004138 OK Order and Referring Only - DentistPractitioner - Dentist 0648543074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2010017952MOMDDentist
19035149ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
United Methodist Western Kansas Mexican American Ministries, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jennifer.rapini.p1@direct.chccmo.nextgenshare.com

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": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1194030957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 COLLEGE AVE",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024742",
            "telephone_number": "580-371-2343",
            "fax_number": "580-371-3614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 COLLEGE AVE",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024742",
            "telephone_number": "580-371-2343",
            "fax_number": "580-371-3614"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "606 E Buchanan St # Mo",
            "address_purpose": "LOCATION",
            "city": "California",
            "state": "MO",
            "postal_code": "650181910",
            "country_code": "US",
            "telephone_number": "573-632-2777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "610 E 24th St",
            "address_purpose": "LOCATION",
            "city": "Tishomingo",
            "state": "OK",
            "postal_code": "734603245",
            "country_code": "US",
            "telephone_number": "580-371-2343",
            "fax_number": "580-371-3614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAPINI",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6454",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2010017952",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19035149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

Verify at the official NPI Registry.