Active NPI
Heath A Grote, D.M.D.
- Endodontics
- Champaign, IL
National Provider Identifier
1235184482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 019024132
- Practice address
- 2916 Crossing CT
Suite C
Champaign, IL 61822-6199 - Phone
- (217) 352-5809
- Fax
- (217) 352-5812
- NPI assigned
- May 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 019024132 | IL | Primary |
Addresses
Primary practice location
2916 Crossing CT
Suite C
Champaign, IL 61822-6199
Mailing address
2916 Crossing Court
Suite C
Champaign, IL 61822
Phone (217) 352-5809
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110712000327 | IL | Order and Referring Only - Oral Surgery | 8527246701 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Illinois Endodontics, LLC | Current | Accepting new patients |
Locations
2916 Crossing Ct
Ste C
Champaign, IL 61822
Phone (217) 352-5809
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.
-
- Dental Clinic/Center
- Champaign, IL
- NPI 1629780267
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294358400000",
"number": "1235184482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2916 CROSSING COURT",
"address_2": "SUITE C",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "61822",
"telephone_number": "217-352-5809",
"fax_number": "217-352-5812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2916 CROSSING CT",
"address_2": "SUITE C",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618226199",
"telephone_number": "217-352-5809",
"fax_number": "217-352-5812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROTE",
"first_name": "HEATH",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2011-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "IL",
"license": "019024132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; 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.