Individual provider Active NPI

Pauline E Cahill, DDS

  • General Practice Dentistry
  • Shelby, NC
National Provider Identifier
1194755264
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6658 Issued in NC
Practice address
139 W Ross Grove Road
Shelby, NC 28150-3406
Phone
(704) 482-7986
Fax
(704) 480-9301
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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 6658 NC Primary

Addresses

Primary practice location

139 W Ross Grove Road
Shelby, NC 28150-3406

Mailing address

139 W Ross Grove Road
PO Box 656
Shelby, NC 28150-3406
Phone (704) 482-7986

Other identifiers 2

IdentifierTypeStateIssuer
8990047MedicaidNC
90047OtherNCBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151205000189 NC Practitioner - Oral Surgery 7719294180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6658NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1194755264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 W ROSS GROVE ROAD",
            "address_2": "PO BOX 656",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503406",
            "telephone_number": "704-482-7986",
            "fax_number": "704-480-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 W ROSS GROVE ROAD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503406",
            "telephone_number": "704-482-7986",
            "fax_number": "704-480-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAHILL",
        "first_name": "PAULINE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8990047",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "90047",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

Verify at the official NPI Registry.