Active NPI
Jerry Hamilton Cheesman, D.M.D.
- General Practice Dentistry
- Lake City, FL
National Provider Identifier
1144759333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN11229
- Practice address
- 217 NE Franklin Sreet
Lake City, FL 32055 - Phone
- (386) 752-9914
- Fax
- (386) 758-2180
- NPI assigned
- Jun 9, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN11229 | FL | Primary |
Addresses
Primary practice location
217 NE Franklin Sreet
Lake City, FL 32055
Mailing address
217 NE Franklin Street
Lake City, FL 32055
Phone (386) 752-9914
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 |
|---|---|---|---|
| DN11229 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496966400000",
"number": "1144759333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "217 NE FRANKLIN STREET",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "32055",
"telephone_number": "386-752-9914",
"fax_number": "386-758-2180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "217 NE FRANKLIN SREET",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "32055",
"telephone_number": "386-752-9914",
"fax_number": "386-758-2180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEESMAN",
"first_name": "JERRY",
"middle_name": "HAMILTON",
"name_prefix": "Mr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-09",
"last_updated": "2017-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN11229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.