Individual provider Active NPI

Carl Patterson Norman, DDS

  • General Practice Dentistry
  • Cleveland, OH
National Provider Identifier
1124102215
Registry record updated Aug 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30014544 Issued in OH
Practice address
11900 Shaker Blvd
2ND Floor
Cleveland, OH 44120-1925
Phone
(216) 921-4900
Fax
(216) 921-3809
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30014544 OH Primary

Addresses

Primary practice location

11900 Shaker Blvd
2ND Floor
Cleveland, OH 44120-1925

Mailing address

PO Box 200429
Cleveland, OH 44120-9429
Phone (216) 921-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150407000982 OH Order and Referring Only - Other (Non-Physician) 2567780356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30014544OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343865600000",
    "number": "1124102215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200429",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441209429",
            "telephone_number": "216-921-4900",
            "fax_number": "216-921-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 SHAKER BLVD",
            "address_2": "2ND FLOOR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441201925",
            "telephone_number": "216-921-4900",
            "fax_number": "216-921-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORMAN",
        "first_name": "CARL",
        "middle_name": "PATTERSON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2012-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30014544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.