John Loudermilk, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12009772A Issued in IN

Practice address

621 Broadway St
Portsmouth, OH 45662-4788

Phone

(740) 941-4011

Fax

(740) 961-4010

NPI assigned

Aug 8, 2007

Sex

Male

Sole proprietor

No

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

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Action Committee of Pike County

  • Primary Care Clinic/Center
  • Waverly, OH
  • NPI 1760659171
  Medicare reassignment NPD
• Community Action Committee of Pike County

  • Primary Care Clinic/Center
  • Piketon, OH
  • NPI 1811164254
  NPD

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1215128715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 MARKET ST",
            "city": "PIKETON",
            "state": "OH",
            "postal_code": "456619757",
            "telephone_number": "740-289-2371",
            "fax_number": "740-289-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 BROADWAY ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624788",
            "telephone_number": "740-941-4011",
            "fax_number": "740-961-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUDERMILK",
        "first_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12009772A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia L Long
• George Leroy Long, D.D.S.
• Jessica Dee Loper, CDCA
• Chad D Lore, CNP
• Kyle Louderback
• Alisha Loving
• Denver Lowe
• Jazzy Lowe, SWT
• Sakeethia A Lowry
• Austin Lucas

• Dentist in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.