Individual provider Active NPI

Kent Edward Livermore, DVM

  • Veterinarian
  • Peoria, AZ
National Provider Identifier
1194048611
Registry record updated Mar 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
1125 Issued in AZ
Practice address
7435 W Cactus Rd
Suite 101
Peoria, AZ 85381-5300
Phone
(623) 878-0033
Fax
(623) 878-8037
NPI assigned
Mar 11, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X 1125 AZ Primary

Addresses

Primary practice location

7435 W Cactus Rd
Suite 101
Peoria, AZ 85381-5300

Mailing address

7435 W Cactus Rd
Suite 101
Peoria, AZ 85381-5300
Phone (623) 878-0033

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
1125AZMDVeterinarian

NPI Registry JSON

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268265600000",
    "number": "1194048611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7435 W CACTUS RD",
            "address_2": "SUITE 101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815300",
            "telephone_number": "623-878-0033",
            "fax_number": "623-878-8037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7435 W CACTUS RD",
            "address_2": "SUITE 101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815300",
            "telephone_number": "623-878-0033",
            "fax_number": "623-878-8037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVERMORE",
        "first_name": "KENT",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DVM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-11",
        "last_updated": "2010-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "AZ",
            "license": "1125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; 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.