Individual provider Active NPI

David Randall Barnes, DDS

  • General Practice Dentistry
  • Jackson, TN
National Provider Identifier
1346319506
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8376 Issued in TN
Practice address
609 Skyline Dr
Jackson, TN 38301-3911
Phone
(731) 424-6500
Fax
(731) 427-3687
NPI assigned
Nov 6, 2006
Last updated
Dec 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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 8376 TN Primary

Addresses

Primary practice location

609 Skyline Dr
Jackson, TN 38301-3911

Mailing address

609 Skyline Dr
Jackson, TN 38301-3911
Phone (731) 424-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20161215001169 TN Order and Referring Only - DentistPractitioner - Dentist 7315227097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8376TNMDGeneral Practice Dentistry
8316TNMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1346319506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013911",
            "telephone_number": "731-424-6500",
            "fax_number": "731-427-3687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013911",
            "telephone_number": "731-424-6500",
            "fax_number": "731-427-3687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "DAVID",
        "middle_name": "RANDALL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "8376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.