Individual provider Active NPI

Phillip M Cathey, D.D.S.

  • General Practice Dentistry
  • Roswell, NM
National Provider Identifier
1467567180
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
990 Issued in NM
Practice address
803 W Alameda St
Roswell, NM 88203-3801
Phone
(505) 622-9134
Fax
(505) 622-9146
NPI assigned
Aug 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 990 NM Primary

Addresses

Primary practice location

803 W Alameda St
Roswell, NM 88203-3801

Mailing address

803 W Alameda St
Roswell, NM 88203-3801
Phone (505) 622-9134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20160322000519 NM Order and Referring Only - DentistPractitioner - Dentist 6608173471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
990NMMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467567180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 W ALAMEDA ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882033801",
            "telephone_number": "505-622-9134",
            "fax_number": "505-622-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 W ALAMEDA ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882033801",
            "telephone_number": "505-622-9134",
            "fax_number": "505-622-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CATHEY",
        "first_name": "PHILLIP",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.