NPIMap

Individual provider Active NPI

Thomas E. Turcotte Jr., D.O.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Dixon, IL
National Provider Identifier
1447288303
Registry record updated Feb 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
036.073224 Issued in IL
Practice address
215 E. 1St St., Suite #315
KSB Medical Group
Dixon, IL 61021
Phone
(815) 285-5603
Fax
(815) 285-5813
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 02000967A IN
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 036.073224 IL Primary

Addresses

Primary practice location

215 E. 1St St., Suite #315
KSB Medical Group
Dixon, IL 61021

Mailing address

215 E. 1St St., Suite #315
KSB Medical Group
Dixon, IL 61021
Phone (815) 285-5603

Other identifiers 1

IdentifierTypeStateIssuer
100367750AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.073224ILMDOtolaryngology/Facial Plastic Surgery Physician
02000967AINMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
U S Health Dept of Health & Human Services Past Accepting new patients
KSB Medical Group, Inc. Past Accepting new patients
KSB Medical Group, Inc. Past Accepting new patients
U S Health Dept of Health & Human Services Past Accepting new patients

Organizations & group practices 4

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1447288303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E. 1ST ST., SUITE #315",
            "address_2": "KSB MEDICAL GROUP",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "61021",
            "telephone_number": "815-285-5603",
            "fax_number": "815-285-5813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E. 1ST ST., SUITE #315",
            "address_2": "KSB MEDICAL GROUP",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "61021",
            "telephone_number": "815-285-5603",
            "fax_number": "815-285-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TURCOTTE",
        "first_name": "THOMAS",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "IN",
            "license": "02000967A",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "IL",
            "license": "036.073224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100367750A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; 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.