Individual provider Active NPI

Warren Clyde Flemmer, D.D.S.

  • General Practice Dentistry
  • Lawrenceburg, TN
National Provider Identifier
1942397609
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2912 Issued in TN
Practice address
228 Pulaski Street
Lawrenceburg, TN 38464
Phone
(931) 762-3901
Fax
(931) 762-3991
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS002912 TN
General Practice Dentistry 1223G0001X 2912 TN Primary

Addresses

Primary practice location

228 Pulaski Street
Lawrenceburg, TN 38464

Mailing address

228 Pulaski Street
Lawrenceburg, TN 38464
Phone (931) 762-3901

Other identifiers 2

IdentifierTypeStateIssuer
0017882OtherBLUECROSS BLUESHIELD
0017882OtherTNBCBST - ID #

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
DS002912TNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288569600000",
    "number": "1942397609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 PULASKI STREET",
            "city": "LAWRENCEBURG",
            "state": "TN",
            "postal_code": "38464",
            "telephone_number": "931-762-3901",
            "fax_number": "931-762-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 PULASKI STREET",
            "city": "LAWRENCEBURG",
            "state": "TN",
            "postal_code": "38464",
            "telephone_number": "931-762-3901",
            "fax_number": "931-762-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMMER",
        "first_name": "WARREN",
        "middle_name": "CLYDE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2010-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS002912",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "2912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "0017882",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST  - ID #",
            "identifier": "0017882",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceburg, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; 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.