Individual provider Active NPI

Ronald Dean Brownfield, D.D.S.

  • Dentist
  • Decatur, IL
National Provider Identifier
1487861845
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
331 N Edward St
Decatur, IL 62522-2227
Phone
(217) 423-8542
Fax
(217) 423-6639
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X IL Primary

Addresses

Primary practice location

331 N Edward St
Decatur, IL 62522-2227

Mailing address

331 N Edward St
Decatur, IL 62522-2227
Phone (217) 423-8542

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
I20160727000696 IL Order and Referring Only - DentistPractitioner - Dentist 1052604121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487861845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 N EDWARD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625222227",
            "telephone_number": "217-423-8542",
            "fax_number": "217-423-6639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 N EDWARD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625222227",
            "telephone_number": "217-423-8542",
            "fax_number": "217-423-6639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWNFIELD",
        "first_name": "RONALD",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.