Individual provider Active NPI

Deran Cathey, D.D.S.

  • General Practice Dentistry
  • Coldwater, MS
National Provider Identifier
1942380480
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2795-94 Issued in MS
Practice address
663 W Service Dr
Coldwater, MS 38618-3822
Phone
(662) 622-5500
Fax
(662) 622-0004
NPI assigned
Oct 17, 2006
Last updated
Aug 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2795-94 MS Primary
General Practice Dentistry 1223G0001X 5359 DC
General Practice Dentistry 1223G0001X 9599 MD

Addresses

Primary practice location

663 W Service Dr
Coldwater, MS 38618-3822

Mailing address

663 W Service Dr
Coldwater, MS 38618-3822
Phone (662) 622-5500

Other identifiers 1

IdentifierTypeStateIssuer
00660094MedicaidMS

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

LicenseStateTypeSpecialty
5359DCMDGeneral Practice Dentistry
9599MDMDGeneral Practice Dentistry
2795-94MSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cathey Family Dentistry PLLC General Practice 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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1942380480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "663 W SERVICE DR",
            "city": "COLDWATER",
            "state": "MS",
            "postal_code": "386183822",
            "telephone_number": "662-622-5500",
            "fax_number": "662-622-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 W SERVICE DR",
            "city": "COLDWATER",
            "state": "MS",
            "postal_code": "386183822",
            "telephone_number": "662-622-5500",
            "fax_number": "662-622-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CATHEY",
        "first_name": "DERAN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "2795-94",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "5359",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "9599",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00660094",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coldwater, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.