Individual provider Active NPI

Robert Craig Cain, DDS

  • Periodontics
  • Knoxville, TN
National Provider Identifier
1851396667
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DS7208 Issued in TN
Practice address
2040 Castaic LN
Knoxville, TN 37932-1557
Phone
(865) 246-0460
Fax
(865) 482-0592
NPI assigned
Jun 17, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DS7208 TN Primary

Addresses

Primary practice location

2040 Castaic LN
Knoxville, TN 37932-1557

Mailing address

2040 Castaic LN
Knoxville, TN 37932-1557
Phone (865) 246-0460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20150717001402 TN Order and Referring Only - DentistPractitioner - Dentist 4486967536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS7208TNMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Periodontics, LLC Periodontics PastSince Jul 24, 2022 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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1851396667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 CASTAIC LN",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321557",
            "telephone_number": "865-246-0460",
            "fax_number": "865-482-0592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 CASTAIC LN",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321557",
            "telephone_number": "865-246-0460",
            "fax_number": "865-482-0592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIN",
        "first_name": "ROBERT",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TN",
            "license": "DS7208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.