Active NPI
Robert Bruce Carney III, DDS
- General Practice Dentistry
- Jackson, TN
National Provider Identifier
1255436911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7682
- Practice address
- 311 Summar Dr
Jackson, TN 38301-3930 - Phone
- (731) 423-4400
- Fax
- (731) 423-3923
- NPI assigned
- Sep 14, 2006
- 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 | 7682 | TN | Primary |
Addresses
Primary practice location
311 Summar Dr
Jackson, TN 38301-3930
Mailing address
311 Summar Dr
Jackson, TN 38301-3930
Phone (731) 423-4400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4028786 | Other | TN | BCBS OF TN |
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 |
|---|---|---|---|
| 7682 | TN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Associates Inc | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255436911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 SUMMAR DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383013930",
"telephone_number": "731-423-4400",
"fax_number": "731-423-3923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 SUMMAR DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383013930",
"telephone_number": "731-423-4400",
"fax_number": "731-423-3923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARNEY",
"first_name": "ROBERT",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TN",
"license": "7682",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TN",
"identifier": "4028786",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, TN
- Cardiovascular Clinic of West TN PC
- Care & Cover Homecare PLLC
- Caring Hands Developmental Services Inc.
- Sheila Carlton, NURSE PRACTITIONER
- Adam Carlucci, M.S.
- Robert Bruce Carney Jr., DDS
- Samuel Lee Carney, PHD
- Carol P. Lagrange, O.D., P.C.
- Nekayeh Pennington Carothers, FNP
- Janie Giles Carp, MS, ATR-BC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.