NPIMap

Organization Active NPI

Jerry S. Alvis, D.D.S., P.a.

  • Exclusive Provider Organization
  • Raleigh, NC
National Provider Identifier
1578743597
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
6792 Issued in NC
Legal business name
JERRY S. ALVIS, D.D.S., P.A.
Practice address
5603 Duraleigh Rd
Suite 131
Raleigh, NC 27612-2688
Phone
(919) 782-5752
NPI assigned
Nov 7, 2007
Last updated
Nov 7, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Authorized official

Name
Dr. Jerry Shumate Alvis, D.D.S.NPI 1497790596
Title
Owner/Dentist
Phone
(919) 782-5752

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
Exclusive Provider Organization 302F00000X 6792 NC Primary

Addresses

Primary practice location

5603 Duraleigh Rd
Suite 131
Raleigh, NC 27612-2688

Mailing address

5603 Duraleigh Rd
Suite 131
Raleigh, NC 27612-2688
Phone (919) 782-5752

Other identifiers 3

IdentifierTypeStateIssuer
1455728OtherUNITED CONCORDIA
90065OtherNCBCBS
ZP0000025MedicaidNC

National Provider Directory

National Provider Directory

Locations

5603 Duraleigh Rd
Ste 131
Raleigh, NC 27612
Phone (919) 782-5752

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194393600000",
    "number": "1578743597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5603 DURALEIGH RD",
            "address_2": "SUITE 131",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122688",
            "telephone_number": "919-782-5752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5603 DURALEIGH RD",
            "address_2": "SUITE 131",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122688",
            "telephone_number": "919-782-5752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY S. ALVIS, D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2007-11-07",
        "status": "A",
        "authorized_official_last_name": "ALVIS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "SHUMATE",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "919-782-5752",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NC",
            "license": "6792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1455728",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "90065",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZP0000025",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.