Douglas S Shroyer, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

221 Railroad Ave Rte 48
Blue Mound, IL 62513

Phone

(217) 692-2097

Fax

(217) 692-2102

NPI assigned

Sep 8, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215031448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 RAILROAD AVE RT 48",
            "address_2": "P.O. BOX 376",
            "city": "BLUE MOUND",
            "state": "IL",
            "postal_code": "62513",
            "telephone_number": "217-692-2097",
            "fax_number": "217-692-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 RAILROAD AVE RTE 48",
            "city": "BLUE MOUND",
            "state": "IL",
            "postal_code": "62513",
            "telephone_number": "217-692-2097",
            "fax_number": "217-692-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHROYER",
        "first_name": "DOUGLAS",
        "middle_name": "S",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Suzanne Chlebus, M.S., CCC/SLP
• Rebecca Kraft, PHARMD
• Megan Rae Scott, BCBA
• Julie Kathleen Trimble

• General Practice Dentistry in Blue Mound, IL
• Providers in Blue Mound, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.