Individual provider Active NPI

Charles David Ratcliff, D.M.D., M.S.D.

  • Endodontics
  • Flowood, MS
National Provider Identifier
1730476060
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
ENDO-491-14 Issued in MS
Practice address
201 E Layfair Dr Ste 120
Flowood, MS 39232-7604
Phone
(601) 664-1855
Fax
(601) 664-1856
NPI assigned
Jul 7, 2011
Last updated
Dec 2, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3603-11 MS
Endodontics 1223E0200X ENDO-491-14 MS Primary

Addresses

Primary practice location

201 E Layfair Dr Ste 120
Flowood, MS 39232-7604

Mailing address

201 E Layfair Dr Ste 120
Flowood, MS 39232-7604
Phone (601) 664-1855

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3603-11MSMDDentist
ENDO-491-14MSMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417478400000",
    "number": "1730476060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E LAYFAIR DR STE 120",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392327604",
            "telephone_number": "601-664-1855",
            "fax_number": "601-664-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E LAYFAIR DR STE 120",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392327604",
            "telephone_number": "601-664-1855",
            "fax_number": "601-664-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATCLIFF",
        "first_name": "CHARLES",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2014-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3603-11",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MS",
            "license": "ENDO-491-14",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.

Verify at the official NPI Registry.