Individual provider Active NPI

Kathryn G. Stuart, DDS, MSD

  • Endodontics
  • Carmel, IN
National Provider Identifier
1811080930
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
12008500 Issued in IN
Practice address
2000 E 116TH St
Suite 104
Carmel, IN 46032-3508
Phone
(317) 848-7778
NPI assigned
Oct 2, 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
Endodontics 1223E0200X 12008500 IN Primary

Addresses

Primary practice location

2000 E 116TH St
Suite 104
Carmel, IN 46032-3508

Mailing address

2000 E 116TH St
Suite 104
Carmel, IN 46032-3508
Phone (317) 848-7778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20150610002666 IN Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 4587985973

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12008500INMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811080930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 E 116TH ST",
            "address_2": "SUITE 104",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323508",
            "telephone_number": "317-848-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E 116TH ST",
            "address_2": "SUITE 104",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323508",
            "telephone_number": "317-848-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUART",
        "first_name": "KATHRYN",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IN",
            "license": "12008500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.