Individual provider Active NPI

Charmaine Elizabeth Keffer, DDS

  • Dentist
  • Raleigh, NC
National Provider Identifier
1043491012
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
NC 6954 Issued in NC
Practice address
2721 Rustic Brick Rd
Raleigh, NC 27603-9642
Phone
(919) 329-0472
Fax
(919) 772-0537
NPI assigned
Nov 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NC 6954 NC Primary

Addresses

Primary practice location

2721 Rustic Brick Rd
Raleigh, NC 27603-9642

Mailing address

2721 Rustic Brick Rd
Raleigh, NC 27603-9642
Phone (919) 329-0472

Other identifiers 1

IdentifierTypeStateIssuer
7902249MedicaidNC

Other names 1

  • Charmaine Elizabeth Keffer Other name

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

State licenses

LicenseStateTypeSpecialty
NC 6954NCMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1043491012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 RUSTIC BRICK RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276039642",
            "telephone_number": "919-329-0472",
            "fax_number": "919-772-0537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 RUSTIC BRICK RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276039642",
            "telephone_number": "919-329-0472",
            "fax_number": "919-772-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEFFER",
        "first_name": "CHARMAINE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "NC 6954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7902249",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARMAINE",
            "last_name": "KEFFER",
            "middle_name": "ELIZABETH",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; 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.