Active NPI
Sara B Womack, RDH
- Dental Hygienist
- Madisonville, KY
National Provider Identifier
1053572040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 3344
- Practice address
- 412 N Kentucky Ave
Madisonville, KY 42431-1711 - Phone
- (270) 821-5242
- Fax
- (270) 825-0138
- NPI assigned
- Jun 23, 2008
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 3344 | KY | Primary |
Addresses
Primary practice location
412 N Kentucky Ave
Madisonville, KY 42431-1711
Mailing address
412 N Kentucky Ave
P O Box 1266
Madisonville, KY 42431-1711
Phone (270) 821-5242
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3344 | Other | KY | DENTAL HYGIENE LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3344 | KY | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214179200000",
"number": "1053572040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "412 N KENTUCKY AVE",
"address_2": "P O BOX 1266",
"city": "MADISONVILLE",
"state": "KY",
"postal_code": "424311711",
"telephone_number": "270-821-5242",
"fax_number": "270-825-0138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "412 N KENTUCKY AVE",
"city": "MADISONVILLE",
"state": "KY",
"postal_code": "424311711",
"telephone_number": "270-821-5242",
"fax_number": "270-825-0138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOMACK",
"first_name": "SARA",
"middle_name": "B",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-23",
"last_updated": "2008-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "KY",
"license": "3344",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL HYGIENE LICENSE",
"identifier": "3344",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madisonville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.