Individual provider Active NPI

Carolyn Reamer Blicharz

  • General Practice Dentistry
  • Centerbrook, CT
National Provider Identifier
1821296674
Registry record updated Jan 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
009875 Issued in CT
Practice address
62 Main St
Centerbrook, CT 06409-1001
Phone
(860) 767-0639
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2010

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 009875 CT Primary

Addresses

Primary practice location

62 Main St
Centerbrook, CT 06409-1001

Mailing address

PO Box 222
62 Main Street
Centerbrook, CT 06409-0222
Phone (860) 767-0639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20150528000014 CT Order and Referring Only - DentistPractitioner - Dentist 3274853528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009875CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ernest D. Reamer DMD PC 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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1821296674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 222",
            "address_2": "62 MAIN STREET",
            "city": "CENTERBROOK",
            "state": "CT",
            "postal_code": "064090222",
            "telephone_number": "860-767-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 MAIN ST",
            "city": "CENTERBROOK",
            "state": "CT",
            "postal_code": "064091001",
            "telephone_number": "860-767-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLICHARZ",
        "first_name": "CAROLYN",
        "middle_name": "REAMER",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "009875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerbrook, CT

Sources for this page

Verify at the official NPI Registry.