Individual provider Active NPI

Garry Dennis Teigland, D.O.

  • Psychiatry Physician
  • Danville, IL
National Provider Identifier
1942320064
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036087954 Issued in IL
Practice address
210 Avenue C
Danville, IL 61832-5410
Phone
(217) 442-3200
Fax
(217) 442-7460
NPI assigned
Mar 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036087954 IL Primary

Addresses

Primary practice location

210 Avenue C
Danville, IL 61832-5410

Mailing address

210 Avenue C
Danville, IL 61832-5410
Phone (217) 442-3200

Other identifiers 1

IdentifierTypeStateIssuer
036087954MedicaidIL

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 Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1942320064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 AVENUE C",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325410",
            "telephone_number": "217-442-3200",
            "fax_number": "217-442-7460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 AVENUE C",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325410",
            "telephone_number": "217-442-3200",
            "fax_number": "217-442-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEIGLAND",
        "first_name": "GARRY",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036087954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036087954",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.