Individual provider Active NPI

Kathryn Morley Guild, D.D.S.

  • General Practice Dentistry
  • Indian River, MI
National Provider Identifier
1306042361
Registry record updated Feb 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901019562 Issued in MI
Practice address
2692 South Straits Highway
Indian River, MI 49749-0459
Phone
(231) 238-9346
Fax
(231) 238-0369
NPI assigned
Jun 26, 2007
Last updated
Feb 26, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2015

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 2901019562 MI Primary

Addresses

Primary practice location

2692 South Straits Highway
Indian River, MI 49749-0459

Mailing address

PO Box 459
2692 South Straits Highway
Indian River, MI 49749-0459
Phone (231) 238-9346

Other names 1

  • Dr. Kathryn C Morley Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150423000763 MI Order and Referring Only - Other (Non-Physician) 6204154255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901019562MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Indian River Family Dentistry PLLC 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, 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": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1306042361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "address_2": "2692 SOUTH STRAITS HIGHWAY",
            "city": "INDIAN RIVER",
            "state": "MI",
            "postal_code": "497490459",
            "telephone_number": "231-238-9346",
            "fax_number": "231-238-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2692 SOUTH STRAITS HIGHWAY",
            "city": "INDIAN RIVER",
            "state": "MI",
            "postal_code": "497490459",
            "telephone_number": "231-238-9346",
            "fax_number": "231-238-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILD",
        "first_name": "KATHRYN",
        "middle_name": "MORLEY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901019562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "MORLEY",
            "middle_name": "C",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Indian River, MI

Sources for this page

Verify at the official NPI Registry.