Individual provider Active NPI

Thomas H George, DDS

  • Durable Medical Equipment & Medical Supplies
  • Bourbonnais, IL
National Provider Identifier
1346372695
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Practice address
14 Briarcliff Prof Ctr
Bourbonnais, IL 60914
Phone
(815) 937-4455
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019016353 IL
Dentist 122300000X 019-016353 IL
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

14 Briarcliff Prof Ctr
Bourbonnais, IL 60914

Mailing address

14 Briarcliff Prof Ctr
Bourbonnais, IL 60914-1775
Phone (815) 937-4455

Other practice location 1

14 Briarcliff Prof Ctr
Bourbonnais, IL 60914
Phone (815) 937-4455

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
I20160707002320 IL Order and Referring Only - DentistPractitioner - Dentist 0244522407

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
019-016353ILMDDentist
019016353ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Bourbonnais Sleep Solutions LLC Durable Medical Equipment & Medical Supplies CurrentSince Feb 1, 2018 Accepting new patients
Bourbonnais Sleep Solutions LLC Durable Medical Equipment & Medical Supplies Current Accepting new patients

Locations

14 Briarcliff Prof Ctr
Bourbonnais, IL 60914
Phone (815) 937-4455

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1346372695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 BRIARCLIFF PROF CTR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609141775",
            "telephone_number": "815-937-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 BRIARCLIFF PROF CTR",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "60914",
            "telephone_number": "815-937-4455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Briarcliff Prof Ctr",
            "address_purpose": "LOCATION",
            "city": "Bourbonnais",
            "state": "IL",
            "postal_code": "60914",
            "country_code": "US",
            "telephone_number": "815-937-4455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "THOMAS",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019016353",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-016353",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

Verify at the official NPI Registry.