Individual provider Active NPI

Robert A Kerr, DDS

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1740393354
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9062 Issued in GA
Practice address
1100 Circle 75 Pkwy SE
200
Atlanta, GA 30339-3064
Phone
(770) 980-0558
Fax
(770) 980-1092
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9062 GA Primary

Addresses

Primary practice location

1100 Circle 75 Pkwy SE
200
Atlanta, GA 30339-3064

Mailing address

3269 Craggy PT SE
Atlanta, GA 30339-4302
Phone (770) 436-6081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160310000919 GA Order and Referring Only - DentistPractitioner - Dentist 1557667912

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9062GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Grace S. Gavric, DDS, LLC. General Practice Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740393354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3269 CRAGGY PT SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303394302",
            "telephone_number": "770-436-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CIRCLE 75 PKWY SE",
            "address_2": "200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393064",
            "telephone_number": "770-980-0558",
            "fax_number": "770-980-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "9062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.