Individual provider Active NPI

Andrew G Murphy, DDS

  • Public Health Dentistry
  • Mansfield, LA
National Provider Identifier
1053415174
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
3863 Issued in LA
Practice address
126 Jefferson St
Mansfield, LA 71052
Phone
(318) 872-1557
Fax
(318) 872-3064
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 3863 LA Primary

Addresses

Primary practice location

126 Jefferson St
Mansfield, LA 71052

Mailing address

126 Jefferson St
Mansfield, LA 71052
Phone (318) 872-1557

Other identifiers 1

IdentifierTypeStateIssuer
1838632MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20160531000939 LA Order and Referring Only - DentistPractitioner - Dentist 0345530523

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3863LAMDPublic Health Dentist

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053415174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 JEFFERSON ST",
            "city": "MANSFIELD",
            "state": "LA",
            "postal_code": "71052",
            "telephone_number": "318-872-1557",
            "fax_number": "318-872-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 JEFFERSON ST",
            "city": "MANSFIELD",
            "state": "LA",
            "postal_code": "71052",
            "telephone_number": "318-872-1557",
            "fax_number": "318-872-3064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURPHY",
        "first_name": "ANDREW",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "LA",
            "license": "3863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1838632",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, LA

Sources for this page

Verify at the official NPI Registry.