Individual provider Active NPI

Cynthia Paige McCord, DDS

  • General Practice Dentistry
  • Bushnell, IL
National Provider Identifier
1356430581
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019-028904 Issued in IL
Practice address
525 E Water St
Bushnell, IL 61422-1764
Phone
(309) 772-2124
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019-028904 IL Primary

Addresses

Primary practice location

525 E Water St
Bushnell, IL 61422-1764

Mailing address

525 E Water St
Bushnell, IL 61422-1764
Phone (309) 772-2124

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
I20150624003019 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5395056873

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-028904ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433376000000",
    "number": "1356430581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E WATER ST",
            "city": "BUSHNELL",
            "state": "IL",
            "postal_code": "614221764",
            "telephone_number": "309-772-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E WATER ST",
            "city": "BUSHNELL",
            "state": "IL",
            "postal_code": "614221764",
            "telephone_number": "309-772-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORD",
        "first_name": "CYNTHIA",
        "middle_name": "PAIGE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2015-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-028904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bushnell, IL

Sources for this page

Verify at the official NPI Registry.