Individual provider Active NPI

Eric N. Kerr, DDS

  • Periodontics
  • Charlotte, NC
National Provider Identifier
1346432267
Registry record updated Aug 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
8466 Issued in NC
Practice address
3535 Randolph Rd
Suite 103-R
Charlotte, NC 28211-1086
Phone
(704) 365-0123
Fax
(704) 364-8640
NPI assigned
Aug 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 8466 NC Primary

Addresses

Primary practice location

3535 Randolph Rd
Suite 103-R
Charlotte, NC 28211-1086

Mailing address

3535 Randolph Rd
Suite 103-R
Charlotte, NC 28211-1086
Phone (704) 365-0123

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
I20140616000368 NC Order and Referring Only - DentistPractitioner - Oral SurgeryPractitioner - Dentist 4587888433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8466NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rubins,Vagianos,Tolmie & Corsig, DDS, PA Periodontics 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": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1346432267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 RANDOLPH RD",
            "address_2": "SUITE 103-R",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111086",
            "telephone_number": "704-365-0123",
            "fax_number": "704-364-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 RANDOLPH RD",
            "address_2": "SUITE 103-R",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111086",
            "telephone_number": "704-365-0123",
            "fax_number": "704-364-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "ERIC",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-14",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NC",
            "license": "8466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.