Individual provider Active NPI

Christopher William Painton, D.D.S

  • General Practice Dentistry
  • Mattoon, IL
National Provider Identifier
1447512975
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.029037 Issued in IL
Practice address
1011 Charleston Ave E
Mattoon, IL 61938-6226
Phone
(217) 235-5900
NPI assigned
Jun 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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 019.029037 IL Primary

Addresses

Primary practice location

1011 Charleston Ave E
Mattoon, IL 61938-6226

Mailing address

1011 Charleston Ave E
Mattoon, IL 61938-6226

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
I20160603000487 IL Order and Referring Only - DentistPractitioner - Dentist 4082904081

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.029037ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1447512975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 CHARLESTON AVE E",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619386226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 CHARLESTON AVE E",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619386226",
            "telephone_number": "217-235-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAINTON",
        "first_name": "CHRISTOPHER",
        "middle_name": "WILLIAM",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-11",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.029037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattoon, IL

Sources for this page

Verify at the official NPI Registry.