Individual provider Active NPI

Carol Poirrier

  • Registered Nurse
  • Port Orange, FL
National Provider Identifier
1003269572
Registry record updated Jul 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN291297L Issued in PA
Practice address
5535 S Williamson Blvd Ste 774
Port Orange, FL 32128-8321
Phone
(888) 458-3620
NPI assigned
Jul 19, 2016
Last updated
Jul 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X L1-0048975 DE
Registered Nurse 163W00000X RN291297L PA Primary
Registered Nurse 163W00000X RN9230081 FL

Addresses

Primary practice location

5535 S Williamson Blvd Ste 774
Port Orange, FL 32128-8321

Mailing address

111 Pinnacle Point Dr
Lancaster, PA 17601-1772

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

LicenseStateTypeSpecialty
L1-0048975DEMDRegistered Nurse
RN9230081FLMDRegistered Nurse
RN291297LPAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1003269572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 PINNACLE POINT DR",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176011772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 S WILLIAMSON BLVD STE 774",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321288321",
            "telephone_number": "888-458-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POIRRIER",
        "first_name": "CAROL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0048975",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN291297L",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9230081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; 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.