NPIMap

Organization Active NPI

Kenny B Carter Jr MD PLLC

  • Otolaryngology Physician
  • Frisco, TX
National Provider Identifier
1639458938
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
N9178 Issued in TX
Legal business name
KENNY B CARTER JR MD PLLC
Practice address
8380 Warren Pkwy
Suite 504
Frisco, TX 75034-4198
Phone
(972) 596-4005
Fax
(972) 985-1253
NPI assigned
Aug 4, 2011
Last updated
Aug 4, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2011

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

Authorized official

Name
Dr. Kenny B Carter Jr., MDNPI 1043307804
Title
Owner
Phone
(972) 596-4005

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
Otolaryngology Physician 207Y00000X N9178 TX Primary

Addresses

Primary practice location

8380 Warren Pkwy
Suite 504
Frisco, TX 75034-4198

Mailing address

8380 Warren Pkwy
Suite 504
Frisco, TX 75034-4198
Phone (972) 596-4005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110915000279 TX Part B Supplier - Clinic/Group Practice 6507037918 Receives reassigned benefits from 4 practitioners
Practice locations: Frisco, TX

National Provider Directory

National Provider Directory

Locations

8380 Warren Pkwy
Ste 504
Frisco, TX 75034
Phone (972) 596-4005

Practitioners & affiliated clinicians

Practitioners 4

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": "1312416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312416000000",
    "number": "1639458938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8380 WARREN PKWY",
            "address_2": "SUITE 504",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344198",
            "telephone_number": "972-596-4005",
            "fax_number": "972-985-1253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8380 WARREN PKWY",
            "address_2": "SUITE 504",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750344198",
            "telephone_number": "972-596-4005",
            "fax_number": "972-985-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNY B CARTER JR MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-04",
        "last_updated": "2011-08-04",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "KENNY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-596-4005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "N9178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.