Active NPI
Mark Robert Rehermann, D.M.D.
- Dentist
- Fort Stewart, GA
National Provider Identifier
1992152904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS041017
- Practice address
- 351 W. 6TH Street
BLDG 440
Fort Stewart, GA 31314 - Phone
- (011) 822-7917
- NPI assigned
- May 19, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS041017 | PA | Primary |
Addresses
Primary practice location
351 W. 6TH Street
BLDG 440
Fort Stewart, GA 31314
Mailing address
351 W. 6TH Street
BLDG 440
Fort Stewart, GA 31314
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 |
|---|---|---|---|
| DS041017 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539734400000",
"number": "1992152904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "351 W. 6TH STREET",
"address_2": "BLDG 440",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "31314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "351 W. 6TH STREET",
"address_2": "BLDG 440",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "31314",
"telephone_number": "011-822-7917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REHERMANN",
"first_name": "MARK",
"middle_name": "ROBERT",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-05-19",
"last_updated": "2018-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS041017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Stewart, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.