NPIMap

Organization Active NPI

Kathleen S. Boyd, DDS, PA

  • Endodontics
  • Salisbury, NC
National Provider Identifier
1417158874
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
6007 Issued in NC
Legal business name
KATHLEEN S. BOYD, DDS, PA
Practice address
640 Statesville Blvd
Suite 3
Salisbury, NC 28144-2282
Phone
(704) 637-3636
Fax
(704) 637-3184
NPI assigned
May 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kathleen S Boyd, D.D.S.NPI 1164478335
Title
Endodontist
Phone
(704) 637-3636

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 6007 NC Primary

Addresses

Primary practice location

640 Statesville Blvd
Suite 3
Salisbury, NC 28144-2282

Mailing address

640 Statesville Blvd
Suite 3
Salisbury, NC 28144-2282
Phone (704) 637-3636

Other identifiers 6

IdentifierTypeStateIssuer
4010411OtherTNBCBS
341264OtherBCBS TRIGON
8990893MedicaidNC
90893OtherNCBCBS
V06007OtherTXBCBS
795487OtherUNITED CONCORDIA

National Provider Directory

National Provider Directory
Tax ID family
Bright Smile Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417158874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 STATESVILLE BLVD",
            "address_2": "SUITE 3",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442282",
            "telephone_number": "704-637-3636",
            "fax_number": "704-637-3184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 STATESVILLE BLVD",
            "address_2": "SUITE 3",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442282",
            "telephone_number": "704-637-3636",
            "fax_number": "704-637-3184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHLEEN S. BOYD, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ENDODONTIST",
        "authorized_official_telephone_number": "704-637-3636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "NC",
            "license": "6007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4010411",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TRIGON",
            "identifier": "341264",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8990893",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "90893",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "V06007",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "795487",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.