Rodney Covenah, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019021494 Issued in IL

Practice address

651 W Terra Cotta Ave
Crystal Lake, IL 60014-3404

Phone

(815) 788-7100

Fax

(815) 788-7138

NPI assigned

Oct 25, 2006

Sex

Male

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1467536649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 W TERRA COTTA AVE",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143404",
            "telephone_number": "815-788-7100",
            "fax_number": "815-788-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 W TERRA COTTA AVE",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143404",
            "telephone_number": "815-788-7100",
            "fax_number": "815-788-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVENAH",
        "first_name": "RODNEY",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019021494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Anne Corson
• Otto Alejandro Corzo, LSW
• Jeanne Coulson
• Counseling With Purpose LLC
• Jenna Coutant, APRN
• Coventry Eyecare Associates, LTD.
• Jennifer Cox, LCPC
• William D. Cox Jr., M.D.
• Emily M. Craigen, DPT
• Laura Ann Crane, D.C.

• General Practice Dentistry in Crystal Lake, IL
• Providers in Crystal Lake, 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 May 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.