Individual provider Active NPI

Dennis Caffery

  • Family Medicine Physician
  • Hopedale, IL
National Provider Identifier
1295825594
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
143 Ford Ave
Hopedale, IL 61747-9485
Phone
(309) 449-3336
Fax
(309) 449-6001
NPI assigned
Oct 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

143 Ford Ave
Hopedale, IL 61747-9485

Mailing address

143 Ford Ave
Hopedale, IL 61747-9485
Phone (309) 449-3336

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091216000562 IL Practitioner - Family Practice 6103966452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-071071ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295825594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 FORD AVE",
            "city": "HOPEDALE",
            "state": "IL",
            "postal_code": "617479485",
            "telephone_number": "309-449-3336",
            "fax_number": "309-449-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 FORD AVE",
            "city": "HOPEDALE",
            "state": "IL",
            "postal_code": "617479485",
            "telephone_number": "309-449-3336",
            "fax_number": "309-449-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAFFERY",
        "first_name": "DENNIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopedale, IL

Sources for this page

Verify at the official NPI Registry.