Individual provider Active NPI

Carolina Vac Nelson, M.D.

  • Family Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1003228131
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME125387 Issued in FL
Practice address
7751 9TH St N Ste 10
St Petersburg, FL 33702-1102
Phone
(727) 521-2424
Fax
(727) 521-2425
NPI assigned
May 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X TRN20292 FL
Family Medicine Physician 207Q00000X ME125387 FL Primary

Addresses

Primary practice location

7751 9TH St N Ste 10
St Petersburg, FL 33702-1102

Mailing address

7751 9TH St N Ste 10
St Petersburg, FL 33702-1102
Phone (727) 521-2424

Other identifiers 1

IdentifierTypeStateIssuer
022106900MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address carolina.nelson@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171028000141 FL Practitioner - Family Practice 0345534996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Florida College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

116 1St St N
St Petersburg, FL 33701-3305
Phone (727) 895-5210

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

7751 9TH St N
Suite 10
St. Petersburg, FL 33702-1102
Phone (727) 521-2424

Hospital & facility affiliations

  • Primecare Home Health Home health agency, Saint Petersburg, FL, CCN 103197
  • Baycare Home Care Inc Home health agency, Largo, FL, CCN 107212
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • St Anthonys Hospital Hospital, Saint Petersburg, FL, CCN 100067
  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127
  • Mease Countryside Hospital Hospital, Safety Harbor, FL, CCN 100265

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME125387FLMDFamily Medicine Physician
TRN20292FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. Family Medicine Current Accepting new patients
Baycare Medical Group, Inc. Family Medicine CurrentSince Dec 1, 2018 Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

12450 Roosevelt Blvd N
Ste 308
St Petersburg, FL 33716
Phone (727) 572-0900

7751 9th St N
Ste 10
St Petersburg, FL 33702
Phone (727) 521-2424

Organizations & group practices 2

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1003228131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7751 9TH ST N STE 10",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337021102",
            "telephone_number": "727-521-2424",
            "fax_number": "727-521-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7751 9TH ST N STE 10",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337021102",
            "telephone_number": "727-521-2424",
            "fax_number": "727-521-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CAROLINA",
        "middle_name": "VAC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-23",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "TRN20292",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME125387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022106900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carolina.nelson@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew St Fl 2",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337593012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.