Carson Keally, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9453 Issued in KY

Practice address

140 Hubbard Rd
Winchester, KY 40391-2412

Phone

(859) 744-0200

NPI assigned

May 30, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Keally Dentistry, PLLC

  • General Practice Dentistry
  • Winchester, KY
  • NPI 1366952814
  NPD (past) Authorized official

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

{
    "created_epoch": "1401408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401408000000",
    "number": "1003228602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 HUBBARD RD",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403912412",
            "telephone_number": "859-744-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 HUBBARD RD",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403912412",
            "telephone_number": "859-744-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEALLY",
        "first_name": "CARSON",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-30",
        "last_updated": "2014-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pascaline Jumbuin, PMHNP-BC
• Karl McClanahan, PSC
• Emily R Kaskey
• Kathryn B Jones MD PSC
• Keally Dentistry, PLLC
• Kentucky Addiction Centers Winchester, LLC
• Kentucky Addiction Centers, LLC
• Kentucky Bariatric, Inc
• Kentucky CVS Pharmacy, L.L.C.
• Kentucky Hospital LLC

• General Practice Dentistry in Winchester, KY
• Providers in Winchester, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.

Verify at the official NPI Registry.