Timothy J Loughran, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

019-018163-1 Issued in IL

Practice address

200 S 16TH St
Herrin, IL 62948-2237

Phone

(618) 988-8130

Fax

(618) 942-2874

NPI assigned

Jul 21, 2005

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 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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Timothy J. Loughran DDS, P.C.

  • Dental Clinic/Center
  • Herrin, IL
  • NPI 1659546406
  NPD (past) Authorized official

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295734119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S 16TH ST",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629482237",
            "telephone_number": "618-988-8130",
            "fax_number": "618-942-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S 16TH ST",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629482237",
            "telephone_number": "618-988-8130",
            "fax_number": "618-942-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUGHRAN",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-018163-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan Primary Care
• Logan Primary Care Service Corp.
• Logan Primary Care Service Corporation
• Logan Primary Care Service Corporation
• Jessica Lohman, NP
• Joshua Caleb Loyd, FNP-BC
• Jamie Lyn Mabry, APN/CNP
• Mackmalter Enterprises, Inc.
• Rhett A Macneille, MD
• Abdul Rashid Majid, M.D.

• Dentist in Herrin, IL
• Providers in Herrin, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.