Individual provider Active NPI

Patricia Merkley, D.M.D. AND R.N.

  • General Practice Dentistry
  • Marble Hill, MO
National Provider Identifier
1952464372
Registry record updated Oct 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2006020090 Issued in MO
Practice address
109 Hwy 51 North
Marble Hill, MO 63764
Phone
(573) 238-2725
Fax
(573) 238-3795
NPI assigned
Dec 18, 2006
Last updated
Oct 29, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2006020090 MO Primary

Addresses

Primary practice location

109 Hwy 51 North
Marble Hill, MO 63764

Mailing address

109 Hwy 51 North
Marble Hill, MO 63764
Phone (573) 238-2725

Other identifiers 1

IdentifierTypeStateIssuer
1952464372MedicaidMO

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2006020090MOMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288310400000",
    "number": "1952464372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 HWY 51 NORTH",
            "city": "MARBLE HILL",
            "state": "MO",
            "postal_code": "63764",
            "telephone_number": "573-238-2725",
            "fax_number": "573-238-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 HWY 51 NORTH",
            "city": "MARBLE HILL",
            "state": "MO",
            "postal_code": "63764",
            "telephone_number": "573-238-2725",
            "fax_number": "573-238-3795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERKLEY",
        "first_name": "PATRICIA",
        "credential": "D.M.D. AND R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2010-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2006020090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952464372",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marble Hill, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.