Individual provider Active NPI

Carolyn Trainer, PA-C

  • Medical Physician Assistant
  • Westminster, MD
National Provider Identifier
1053770636
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0006042 Issued in MD
Practice address
912 Washington Rd
Westminster, MD 21157-5827
Phone
(410) 848-4121
Fax
(410) 848-2827
NPI assigned
Feb 11, 2016
Last updated
Mar 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0006042 MD Primary

Addresses

Primary practice location

912 Washington Rd
Westminster, MD 21157-5827

Mailing address

912 Washington Rd
Westminster, MD 21157-5827
Phone (410) 848-4121

Other identifiers 1

IdentifierTypeStateIssuer
208571200MedicaidMD

Other names 1

  • Carolyn Funke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160512001308 MD Practitioner - Physician Assistant 2567751654 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0006042MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1053770636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 WASHINGTON RD",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575827",
            "telephone_number": "410-848-4121",
            "fax_number": "410-848-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 WASHINGTON RD",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575827",
            "telephone_number": "410-848-4121",
            "fax_number": "410-848-2827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAINER",
        "first_name": "CAROLYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-11",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0006042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208571200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "FUNKE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Westminster, MD

Sources for this page

Verify at the official NPI Registry.