Individual provider Active NPI

Anne Bollmeier

  • General Practice Dentistry
  • O Fallon, IL
National Provider Identifier
1235544024
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019029802 Issued in IL
Practice address
2010 W Highway 50
O Fallon, IL 62269-1628
Phone
(618) 622-8888
NPI assigned
Jun 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019029802 IL Primary

Addresses

Primary practice location

2010 W Highway 50
O Fallon, IL 62269-1628

Mailing address

2010 W Highway 50
O Fallon, IL 62269-1628
Phone (618) 622-8888

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
I20151209001975 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8628379088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1235544024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 W HIGHWAY 50",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691628",
            "telephone_number": "618-622-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 W HIGHWAY 50",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691628",
            "telephone_number": "618-622-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLMEIER",
        "first_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019029802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

Verify at the official NPI Registry.