Active NPI
James Bleak Powell, DDS
- Dentist
- Fort Campbell, KY
National Provider Identifier
1922291855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6586747-9921
- Practice address
- USA Dentac 21St Street
BLDG 2441
Fort Campbell, KY 42223-5369 - Phone
- (270) 798-8614
- Fax
- (270) 956-0266
- NPI assigned
- Aug 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6586747-9921 | UT | Primary |
Addresses
Primary practice location
USA Dentac 21St Street
BLDG 2441
Fort Campbell, KY 42223-5369
Mailing address
USA Dentac 21St Street
BLDG 2441
Fort Campbell, KY 42223-5369
Phone (270) 798-8614
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6586747-9921 | UT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187827200000",
"number": "1922291855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "USA DENTAC 21ST STREET",
"address_2": "BLDG 2441",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422235369",
"telephone_number": "270-798-8614",
"fax_number": "270-956-0266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "USA DENTAC 21ST STREET",
"address_2": "BLDG 2441",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "422235369",
"telephone_number": "270-798-8614",
"fax_number": "270-956-0266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "JAMES",
"middle_name": "BLEAK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-23",
"last_updated": "2007-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "6586747-9921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Campbell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.