Individual provider Active NPI

Kerry Brandt Dunbar, M.D.

  • Gastroenterology Physician
  • Dallas, TX
National Provider Identifier
1073560223
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
D61475 Issued in MD
Practice address
4500 S Lancaster Rd
Dallas VA Medical Center Gi Lab, Ca 111-B1
Dallas, TX 75216-7167
Phone
(214) 857-1603
Fax
(214) 857-1571
NPI assigned
May 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D61475 MD
Gastroenterology Physician 207RG0100X D61475 MD Primary

Addresses

Primary practice location

4500 S Lancaster Rd
Dallas VA Medical Center Gi Lab, Ca 111-B1
Dallas, TX 75216-7167

Mailing address

4500 S Lancaster Rd
Dallas VA Medical Center Gi Lab, Ca 111-B1
Dallas, TX 75216-7167
Phone (214) 857-1603

Other identifiers 1

IdentifierTypeStateIssuer
405237400MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110815000827 TX Order and Referring Only - Internal MedicinePractitioner - GastroenterologyPractitioner - Internal Medicine 2466427026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D61475MDMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1073560223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 S LANCASTER RD",
            "address_2": "DALLAS VA MEDICAL CENTER GI LAB, CA 111-B1",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167167",
            "telephone_number": "214-857-1603",
            "fax_number": "214-857-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S LANCASTER RD",
            "address_2": "DALLAS VA MEDICAL CENTER GI LAB, CA 111-B1",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167167",
            "telephone_number": "214-857-1603",
            "fax_number": "214-857-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNBAR",
        "first_name": "KERRY",
        "middle_name": "BRANDT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D61475",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MD",
            "license": "D61475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405237400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.