Individual provider Active NPI

Charles Kevin Meunier, DMD

  • Dentist
  • Shepherdsville, KY
National Provider Identifier
1609897040
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6692 Issued in KY
Practice address
3564 Willow Way
Shepherdsville, KY 40165-8984
Phone
(502) 955-1606
Fax
(502) 955-1439
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6692 KY Primary

Addresses

Primary practice location

3564 Willow Way
Shepherdsville, KY 40165-8984

Mailing address

3564 Willow Way
Shepherdsville, KY 40165-8984
Phone (502) 955-1606

Other identifiers 1

IdentifierTypeStateIssuer
60066925MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20161117002699 KY Order and Referring Only - DentistPractitioner - Dentist 8628357480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6692KYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1609897040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3564 WILLOW WAY",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401658984",
            "telephone_number": "502-955-1606",
            "fax_number": "502-955-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3564 WILLOW WAY",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401658984",
            "telephone_number": "502-955-1606",
            "fax_number": "502-955-1439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEUNIER",
        "first_name": "CHARLES",
        "middle_name": "KEVIN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "6692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60066925",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shepherdsville, KY

Sources for this page

Verify at the official NPI Registry.