Active NPI
Nimrata Pandher
- Dentist
- Rockford, IL
National Provider Identifier
1497124671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019030460
- Practice address
- 1200 W State St
Rockford, IL 61102-2112 - Phone
- (815) 490-1600
- NPI assigned
- Sep 17, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019030460 | IL | Primary |
Addresses
Primary practice location
1200 W State St
Rockford, IL 61102-2112
Mailing address
1200 W State St
Rockford, IL 61102-2112
Phone (815) 490-1600
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161013001681 | IL | Order and Referring Only - Dentist | 1456649003 |
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": "1442448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468540800000",
"number": "1497124671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 W STATE ST",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611022112",
"telephone_number": "815-490-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 W STATE ST",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611022112",
"telephone_number": "815-490-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANDHER",
"first_name": "NIMRATA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-17",
"last_updated": "2016-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019030460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; 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.