Individual provider Active NPI

Cary Alexander Keen

  • Dentist
  • Thomasville, NC
National Provider Identifier
1205219839
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10122 Issued in NC
Practice address
210 Arthur Dr
Thomasville, NC 27360-6275
Phone
(336) 476-6129
NPI assigned
Jul 1, 2015
Last updated
Jul 1, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10122 NC Primary

Addresses

Primary practice location

210 Arthur Dr
Thomasville, NC 27360-6275

Mailing address

338 Arbor TRL
Thomasville, NC 27360-7170
Phone (336) 707-7456

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
I20160222001135 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8224333729

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10122NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Smith, Lanning & Bundy Past Accepting new patients
Smith Bundy and Fisher Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1205219839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 ARBOR TRL",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273607170",
            "telephone_number": "336-707-7456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 ARTHUR DR",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273606275",
            "telephone_number": "336-476-6129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEN",
        "first_name": "CARY",
        "middle_name": "ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "10122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, NC

Sources for this page

Verify at the official NPI Registry.