Active NPI
Prabhjot Singh
- Family Medicine Physician
- Peoria, IL
National Provider Identifier
1700292828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 125065853
- Practice address
- 815 Main St Ste a
Peoria, IL 61602-1080 - Phone
- (309) 672-4977
- Fax
- (309) 672-2580
- NPI assigned
- Jul 9, 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 125065853 | IL | Primary |
Addresses
Primary practice location
815 Main St Ste a
Peoria, IL 61602-1080
Mailing address
815 Main St Ste a
Peoria, IL 61602-1080
Phone (309) 672-4977
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: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150605002735 | IL | Order and Referring Only - Family Practice | 3870814569 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125065853 | IL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404864000000",
"number": "1700292828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 MAIN ST STE A",
"city": "PEORIA",
"state": "IL",
"postal_code": "616021080",
"telephone_number": "309-672-4977",
"fax_number": "309-672-2580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 MAIN ST STE A",
"city": "PEORIA",
"state": "IL",
"postal_code": "616021080",
"telephone_number": "309-672-4977",
"fax_number": "309-672-2580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SINGH",
"first_name": "PRABHJOT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-09",
"last_updated": "2014-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "125065853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; 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.