Active NPI
Carryl Villanueva
- Case Manager/Care Coordinator
- Medford, OR
National Provider Identifier
1003277211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 3397 Delta Waters Rd
Medford, OR 97504-5852 - Phone
- (541) 772-4648
- Fax
- (541) 734-2410
- NPI assigned
- Mar 15, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
3397 Delta Waters Rd
Medford, OR 97504-5852
Mailing address
3397 Delta Waters Rd
Medford, OR 97504-5852
Phone (541) 772-4648
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458000000000",
"number": "1003277211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3397 DELTA WATERS RD",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975045852",
"telephone_number": "541-772-4648",
"fax_number": "541-734-2410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3397 DELTA WATERS RD",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975045852",
"telephone_number": "541-772-4648",
"fax_number": "541-734-2410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLANUEVA",
"first_name": "CARRYL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-15",
"last_updated": "2016-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.