Individual provider Active NPI

Ronald A Murphy, DMD

  • General Practice Dentistry
  • Batavia, IL
National Provider Identifier
1811035454
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019-025940 Issued in IL
Practice address
1605 W Wilson St
Suite 114
Batavia, IL 60510-1627
Phone
(630) 879-7642
Fax
(630) 879-3598
NPI assigned
Feb 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019-025940 IL Primary

Addresses

Primary practice location

1605 W Wilson St
Suite 114
Batavia, IL 60510-1627

Mailing address

1605 W Wilson St
Suite 114
Batavia, IL 60510-1627
Phone (630) 879-7642

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
I20150527003028 IL Order and Referring Only - DentistPractitioner - Dentist 3375863624

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-025940ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1170547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1811035454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 W WILSON ST",
            "address_2": "SUITE 114",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605101627",
            "telephone_number": "630-879-7642",
            "fax_number": "630-879-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 W WILSON ST",
            "address_2": "SUITE 114",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605101627",
            "telephone_number": "630-879-7642",
            "fax_number": "630-879-3598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURPHY",
        "first_name": "RONALD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-04",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-025940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batavia, IL

Sources for this page

Verify at the official NPI Registry.