Jeffrey Poulter, M.D.
Jeffrey Poulter, M.D. is a Plastic Surgery Physician in Bloomington, IL, registered under NPI 1174521074. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 1505 EASTLAND DR STE 350, Bloomington, IL 61701. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| MDR5N96 | MO | Plastic and Reconstructive Surgery… |
This provider holds licence MDR5N96 issued in MO. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
What Plastic Surgery covers
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. NUCC Health Care Provider Taxonomy, code 208200000X
All registered taxonomy codes
This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 208200000X | Plastic Surgery Physician | — | IL | primary |
| 2086S0122X | Plastic and Reconstructive Surgery Physician Plastic and Reconstructive Surgery | MDR5N96 | MO | |
| 2086S0122X | Plastic and Reconstructive Surgery Physician Plastic and Reconstructive Surgery | — | IL |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1174521074 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Jul 13, 2005 |
| Last updated | Dec 19, 2007 |
| Status | Active |
| Sole proprietor | Yes |
| Credential | M.D. |
| Practice address |
1505 EASTLAND DR STE 350 Bloomington, IL 61701 (309) 663-1222 Fax (309) 663-0580 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 1 | 7 | 4 | 5 | 2 | 1 | 0 | 7 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 1 | 5 | 4 | 1 | 2 | 2 | 0 | 5 |
Sum = 46 · next multiple of 10 = 50 · check digit = 4 · actual last digit = 4
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.