Active NPI
Kellie Paxton, D.M.D., M.S.
- Endodontics
- Mooresville, NC
National Provider Identifier
1013930445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 9583
- Practice address
- 202 Williamson Rd
Suite 202
Mooresville, NC 28117-7610 - Phone
- (704) 799-0110
- NPI assigned
- Jul 26, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 9583 | NC | Primary |
Addresses
Primary practice location
202 Williamson Rd
Suite 202
Mooresville, NC 28117-7610
Mailing address
202 Williamson Rd
Suite 202
Mooresville, NC 28117-7610
Phone (704) 799-0110
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9583 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384732800000",
"number": "1013930445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 WILLIAMSON RD",
"address_2": "SUITE 202",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281177610",
"telephone_number": "704-799-0110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 WILLIAMSON RD",
"address_2": "SUITE 202",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281177610",
"telephone_number": "704-799-0110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAXTON",
"first_name": "KELLIE",
"name_prefix": "Dr.",
"credential": "D.M.D., M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2013-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NC",
"license": "9583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mooresville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.