Jacob E Stimmel

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.33337 Issued in IL

Practice address

2817 Reed Rd
Bloomington, IL 61704-8294

Phone

(309) 662-5921

NPI assigned

Sep 10, 2021

Last updated

Sep 10, 2021By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jake.stimmel.p32@direct.fhn-fqhc.nextgenshare.com

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1336818533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 ROBERT DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618216023",
            "telephone_number": "217-840-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 REED RD",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617048294",
            "telephone_number": "309-662-5921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIMMEL",
        "first_name": "JACOB",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-10",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.33337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerry Rae Stephens, LCSW
• Madelyn J Stevens
• Michael Jonathan Stevens, PHD
• Serina Stevenson
• Casey J Stieren, DPT
• Chris Stipher
• Amy J Stites, PA-C
• Mark Stivers, M.D.
• Nicole A Stockburger
• Alicia Stoddard Foley, PMHNP-BC

• General Practice Dentistry in Bloomington, IL
• Providers in Bloomington, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.