Active NPI
Kim Collins-Dunham
- Social Worker
- Rantoul, IL
National Provider Identifier
1568873289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 1340 Abram Dr
Rantoul, IL 61866-3485 - Phone
- (757) 358-0032
- NPI assigned
- May 15, 2014
- Last updated
- May 15, 2014
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | IL | Primary |
Addresses
Primary practice location
1340 Abram Dr
Rantoul, IL 61866-3485
Mailing address
1340 Abram Dr
Rantoul, IL 61866-3485
Phone (757) 358-0032
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400112000000",
"number": "1568873289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1340 ABRAM DR",
"city": "RANTOUL",
"state": "IL",
"postal_code": "618663485",
"telephone_number": "757-358-0032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1340 ABRAM DR",
"city": "RANTOUL",
"state": "IL",
"postal_code": "618663485",
"telephone_number": "757-358-0032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS-DUNHAM",
"first_name": "KIM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-15",
"last_updated": "2014-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rantoul, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.