Individual provider Active NPI

Kurt S Rothermel, DDS

  • Dentist
  • Crowley, LA
National Provider Identifier
1497801450
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4310 Issued in LA
Practice address
817 North Avenue K
Crowley, LA 70526
Phone
(337) 783-2113
Fax
(337) 783-2175
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
No

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
Dentist 122300000X 4310 LA Primary

Addresses

Primary practice location

817 North Avenue K
Crowley, LA 70526

Mailing address

PO Drawer 509
Crowley, LA 70527-0509
Phone (337) 783-2113

Other identifiers 1

IdentifierTypeStateIssuer
1843105MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20161010001249 LA Order and Referring Only - DentistPractitioner - Dentist 3072801992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4310LAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rothermel Family Dentistry LLC Dentist 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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497801450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO DRAWER 509",
            "city": "CROWLEY",
            "state": "LA",
            "postal_code": "705270509",
            "telephone_number": "337-783-2113",
            "fax_number": "337-783-2175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 NORTH AVENUE K",
            "city": "CROWLEY",
            "state": "LA",
            "postal_code": "70526",
            "telephone_number": "337-783-2113",
            "fax_number": "337-783-2175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHERMEL",
        "first_name": "KURT",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "4310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1843105",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crowley, LA

Sources for this page

Verify at the official NPI Registry.