NPIMap

Organization Active NPI

Ronald Weems Jr. P.C.

Doing business as Collinsville Dental Care

  • Dentist
  • Collinsville, IL
National Provider Identifier
1205008240
Registry record updated May 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019025159 Issued in IL
Legal business name
RONALD WEEMS JR. P.C.
Doing business as
Collinsville Dental Care
Practice address
1099 Belt Line Rd
Suite J-K
Collinsville, IL 62234-4380
Phone
(618) 346-2006
Fax
(618) 346-2066
NPI assigned
Mar 31, 2008
Last updated
May 31, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
RONALD WEEMS JR. P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 31, 2012

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

Authorized official

Name
Mrs. Amanda Henderson
Title
Business Assistant
Phone
(618) 288-6201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019025159 IL Primary

Addresses

Primary practice location

1099 Belt Line Rd
Suite J-K
Collinsville, IL 62234-4380

Mailing address

26 Ginger Creek Pkwy
PO Box 430
Glen Carbon, IL 62034-3502
Phone (618) 288-6201

Other names 1

  • Collinsville Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ronald Weems Jr PC5 organizations share this tax ID, including this one
Part of
Ronald Weems Jr PC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1099 Belt Line Rd
Ste Jk
Collinsville, IL 62234
Phone (618) 346-2006

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338422400000",
    "number": "1205008240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 GINGER CREEK PKWY",
            "address_2": "PO BOX 430",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343502",
            "telephone_number": "618-288-6201",
            "fax_number": "618-288-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 BELT LINE RD",
            "address_2": "SUITE J-K",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344380",
            "telephone_number": "618-346-2006",
            "fax_number": "618-346-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD WEEMS JR. P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RONALD WEEMS JR. P.C.",
        "enumeration_date": "2008-03-31",
        "last_updated": "2012-05-31",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BUSINESS ASSISTANT",
        "authorized_official_telephone_number": "618-288-6201",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019025159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Collinsville Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Collinsville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2012; 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.