Active NPI
Lester J. Fahrner, M.D.
- Dermatology Physician
- Champaign, IL
National Provider Identifier
1811903677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 036-077871
- Practice address
- 101 W University Ave
Champaign, IL 61820-3909 - Phone
- (217) 366-1248
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 036-077871 | IL | Primary |
Addresses
Primary practice location
101 W University Ave
Champaign, IL 61820-3909
Mailing address
101 W University Ave
Champaign, IL 61820-3909
Phone (217) 366-8107
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070004611 | Other | RAILROAD MEDICARE | |
| 279500 | Other | MEDICARE GROUP | |
| 036077871 1 | Medicaid | IL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-077871 | IL | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Towner County Medical Center Inc | Past | Accepting new patients | |
| Allina Health System | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Minneapolis, MN
- NPI 1467758813
-
- Rural Acute Care Hospital
- Cando, ND
- NPI 1154352169
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413331200000",
"number": "1811903677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 W UNIVERSITY AVE",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618203909",
"telephone_number": "217-366-8107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W UNIVERSITY AVE",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618203909",
"telephone_number": "217-366-1248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAHRNER",
"first_name": "LESTER",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2014-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "IL",
"license": "036-077871",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "070004611",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "279500",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036077871 1",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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.