NPIMap

Organization Active NPI

Philip B. Kepp, DDS,PC

  • General Practice Dentistry
  • Mattoon, IL
National Provider Identifier
1275569923
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PHILIP B. KEPP, DDS,PC
Practice address
601 Broadway Ave
Mattoon, IL 61938-4340
Phone
(217) 235-0556
Fax
(217) 234-7243
NPI assigned
Jun 24, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Philip B. Kepp, DDSNPI 1063446128
Title
President
Phone
(217) 235-0556

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

601 Broadway Ave
Mattoon, IL 61938-4340

Mailing address

601 Broadway Ave
Mattoon, IL 61938-4340
Phone (217) 235-0556

National Provider Directory

National Provider Directory

Locations

601 Broadway Ave
Mattoon, IL 61938
Phone (217) 235-0556

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275569923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 BROADWAY AVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384340",
            "telephone_number": "217-235-0556",
            "fax_number": "217-234-7243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 BROADWAY AVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384340",
            "telephone_number": "217-235-0556",
            "fax_number": "217-234-7243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP B. KEPP, DDS,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KEPP",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-235-0556",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattoon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.