Active NPI
Warren Clyde Flemmer, D.D.S.
- General Practice Dentistry
- Lawrenceburg, TN
National Provider Identifier
1942397609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2912
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0017882 | Other | BLUECROSS BLUESHIELD | |
| 0017882 | Other | TN | BCBST - 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
| License | State | Type | Specialty |
|---|---|---|---|
| DS002912 | TN | MD | General 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.