Active NPI
Kerry Robin Carder, MD
- Pediatric Dermatology Physician
- Dallas, TX
National Provider Identifier
1952370405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dermatology Physician
- License
- J4021
- Practice address
- 8315 Walnut Hill LN
Suite 135
Dallas, TX 75231-4218 - Phone
- (214) 580-1011
- Fax
- (214) 580-1012
- NPI assigned
- Mar 16, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Dermatology Physician | 207NP0225X | J4021 | TX | Primary |
Addresses
Primary practice location
8315 Walnut Hill LN
Suite 135
Dallas, TX 75231-4218
Mailing address
8315 Walnut Hill LN
Suite 135
Dallas, TX 75231-4218
Phone (214) 580-1011
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 146646801 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Dermatology of Dallas, PA | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CJICAA/Endpoint/CJICAA
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 and National Provider Directory roles.
-
- Specialist
- Dallas, TX
- NPI 1477696466
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429660800000",
"number": "1952370405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8315 WALNUT HILL LN",
"address_2": "SUITE 135",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314218",
"telephone_number": "214-580-1011",
"fax_number": "214-580-1012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8315 WALNUT HILL LN",
"address_2": "SUITE 135",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314218",
"telephone_number": "214-580-1011",
"fax_number": "214-580-1012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARDER",
"first_name": "KERRY",
"middle_name": "ROBIN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-03-16",
"last_updated": "2015-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "207NP0225X",
"taxonomy_group": "",
"desc": "Dermatology, Pediatric Dermatology",
"state": "TX",
"license": "J4021",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "146646801",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.