Active NPI
James A Kerr, DDS
- General Practice Dentistry
- Cottage Grove, MN
National Provider Identifier
1750504619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11505
- Practice address
- 7501 80TH St S Ste 214
Cottage Grove, MN 55016-6063 - Phone
- (651) 459-2300
- NPI assigned
- Apr 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5462 | WI | |
| General Practice Dentistry | 1223G0001X | 11505 | MN | Primary |
Addresses
Primary practice location
7501 80TH St S Ste 214
Cottage Grove, MN 55016-6063
Mailing address
2200 County Road C W Ste 2210
Roseville, MN 55113-2551
Phone (651) 746-2815
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33798100 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5462 | WI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PDG, PA | Past | Accepting new patients | |
| Spring Valley Dentistry Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- Cottage Grove, MN
- NPI 1689122442
-
- Dentist
- Spring Valley, WI
- NPI 1902333941
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607558400000",
"number": "1750504619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 COUNTY ROAD C W STE 2210",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551132551",
"telephone_number": "651-746-2815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7501 80TH ST S STE 214",
"city": "COTTAGE GROVE",
"state": "MN",
"postal_code": "550166063",
"telephone_number": "651-459-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERR",
"first_name": "JAMES",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-10",
"last_updated": "2020-12-10",
"certification_date": "2020-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "5462",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "11505",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "33798100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cottage Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.