Individual provider Active NPI

Richard Lee Carter, D.D.S.

  • General Practice Dentistry
  • Colorado Springs, CO
National Provider Identifier
1497764088
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3248 Issued in CO
Practice address
3204 N Academy Blvd
Suite 210
Colorado Springs, CO 80917-5165
Phone
(719) 591-0750
Fax
(719) 380-8764
NPI assigned
Aug 5, 2006
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 3248 CO Primary

Addresses

Primary practice location

3204 N Academy Blvd
Suite 210
Colorado Springs, CO 80917-5165

Mailing address

3204 N Academy Blvd
Suite 210
Colorado Springs, CO 80917-5165
Phone (719) 591-0750

Other identifiers 1

IdentifierTypeStateIssuer
02032480MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3248COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Richard L. Carter DDS PC Past Accepting new patients
Kenneth C. Pollary DDS PLLC Past Accepting new patients

Organizations & group practices 2

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497764088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3204 N ACADEMY BLVD",
            "address_2": "SUITE 210",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175165",
            "telephone_number": "719-591-0750",
            "fax_number": "719-380-8764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 N ACADEMY BLVD",
            "address_2": "SUITE 210",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175165",
            "telephone_number": "719-591-0750",
            "fax_number": "719-380-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "RICHARD",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "3248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02032480",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.