Jerry Wayne Caudill, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

5408 Issued in KY

Practice address

51 Carrie LN
Campbellsburg, KY 40011-6218

Phone

(502) 414-1114

Fax

(502) 236-0555

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1912006743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 CARRIE LN",
            "city": "CAMPBELLSBURG",
            "state": "KY",
            "postal_code": "400116218",
            "telephone_number": "502-414-1114",
            "fax_number": "502-236-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 CARRIE LN",
            "city": "CAMPBELLSBURG",
            "state": "KY",
            "postal_code": "400116218",
            "telephone_number": "502-414-1114",
            "fax_number": "502-236-0555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 CARRIE LN",
            "address_purpose": "LOCATION",
            "city": "Campbellsburg",
            "state": "KY",
            "postal_code": "400116218",
            "country_code": "US",
            "telephone_number": "502-414-1114",
            "fax_number": "502-236-0555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAUDILL",
        "first_name": "JERRY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "5408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori P Abney, ARNP
• Ann Nesmith DMD 2 PLLC
• Bluegrass Drug Center Inc
• Campbellsburg Chiropractic, PSC
• Cooks Pharmacy Inc
• Damon Gatewood MD PLLC
• Brent Michael Dawson, DC
• Dr. Molly Doerr OD PSC
• David L Embry, D.M.D.

• Dentist in Campbellsburg, KY
• Providers in Campbellsburg, KY by specialty
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.

Verify at the official NPI Registry.