Individual provider Active NPI

Heath A Grote, D.M.D.

  • Endodontics
  • Champaign, IL
National Provider Identifier
1235184482
Registry record updated Jan 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
019024132 Issued in IL
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

Updated by the provider on Jan 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110712000327 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8527246701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.