Individual provider Active NPI

Kevin Arthur Chermak, DVM

  • Veterinarian
  • Jamestown, TN
National Provider Identifier
1063787430
Registry record updated Mar 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
DV0000004768 Issued in TN
Practice address
304 Garrett St
Jamestown, TN 38556-4228
Phone
(931) 704-3454
Fax
(931) 752-4838
NPI assigned
Mar 18, 2012
Last updated
Mar 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X DV0000004768 TN Primary

Addresses

Primary practice location

304 Garrett St
Jamestown, TN 38556-4228

Mailing address

304 Garrett St
Jamestown, TN 38556-4228
Phone (931) 704-3454

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
DV0000004768TNMDVeterinarian

NPI Registry JSON

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

{
    "created_epoch": "1332028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332028800000",
    "number": "1063787430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 GARRETT ST",
            "city": "JAMESTOWN",
            "state": "TN",
            "postal_code": "385564228",
            "telephone_number": "931-704-3454",
            "fax_number": "931-752-4838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 GARRETT ST",
            "city": "JAMESTOWN",
            "state": "TN",
            "postal_code": "385564228",
            "telephone_number": "931-704-3454",
            "fax_number": "931-752-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERMAK",
        "first_name": "KEVIN",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "DVM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-18",
        "last_updated": "2012-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "TN",
            "license": "DV0000004768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2012; 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.