Active NPI
Michael Carraway Foreman, D.M.D., M.S.
- Endodontics
- Lake City, FL
National Provider Identifier
1487852547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN17084
- Practice address
- 239 SW Professional GLN
Lake City, FL 32025-1105 - Phone
- (386) 755-8833
- NPI assigned
- Jul 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN17084 | FL | Primary |
Addresses
Primary practice location
239 SW Professional GLN
Lake City, FL 32025-1105
Mailing address
PO Box 2589
Lake City, FL 32056-2589
Phone (386) 755-8833
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Sep 16, 2018 through Sep 16, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN17084 | FL | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184025600000",
"number": "1487852547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2589",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320562589",
"telephone_number": "386-755-8833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "239 SW PROFESSIONAL GLN",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320251105",
"telephone_number": "386-755-8833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOREMAN",
"first_name": "MICHAEL",
"middle_name": "CARRAWAY",
"name_prefix": "Dr.",
"credential": "D.M.D., M.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-10",
"last_updated": "2007-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "FL",
"license": "DN17084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.