Individual provider Active NPI

John Edward Zegeer, DDS

  • General Practice Dentistry
  • Charleston, WV
National Provider Identifier
1821143454
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2642 Issued in WV
Practice address
504 50TH St SE
Charleston, WV 25304-2024
Phone
(304) 925-7400
Fax
(304) 925-5010
NPI assigned
Jan 24, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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 2642 WV Primary

Addresses

Primary practice location

504 50TH St SE
Charleston, WV 25304-2024

Mailing address

504 50TH St SE
Charleston, WV 25304-2024
Phone (304) 925-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20160331000459 WV Order and Referring Only - DentistPractitioner - Dentist 0143527481

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2642WVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flexcare Infusion Okc, LLC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821143454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 50TH ST SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042024",
            "telephone_number": "304-925-7400",
            "fax_number": "304-925-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 50TH ST SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042024",
            "telephone_number": "304-925-7400",
            "fax_number": "304-925-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEGEER",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "2642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.