Active NPI
Kelvin Demont Exum, M.D.
- Psychiatry Physician
- Dallas, TX
National Provider Identifier
1659567824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 200701556
- Practice address
- 7808 Clodus Fields Dr
Dallas, TX 75251-2206 - Phone
- (972) 770-1032
- Fax
- (469) 484-1785
- NPI assigned
- Sep 20, 2007
- Last updated
- Dec 16, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 200701556 | NC | Primary |
Addresses
Primary practice location
7808 Clodus Fields Dr
Dallas, TX 75251-2206
Mailing address
7808 Clodus Fields Dr
Dallas, TX 75251-2206
Phone (972) 770-1032
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200701556 | NC | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Celso B. Lobao, MD, PA | Past | Accepting new patients |
Interoperability endpoints
- kelvin.exum@hca7.eclinicaldirectplus.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Raleigh, NC
- NPI 1487782835
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418688000000",
"number": "1659567824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7808 CLODUS FIELDS DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752512206",
"telephone_number": "972-770-1032",
"fax_number": "469-484-1785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7808 CLODUS FIELDS DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752512206",
"telephone_number": "972-770-1032",
"fax_number": "469-484-1785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EXUM",
"first_name": "KELVIN",
"middle_name": "DEMONT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-20",
"last_updated": "2014-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "200701556",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.