Individual provider Active NPI

Erin M Carroll, NP, CNM

  • Family Nurse Practitioner
  • North Syracuse, NY
National Provider Identifier
1063415024
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F343403-1 Issued in NY
Practice address
792 N Main St Ste 200
North Syracuse, NY 13212
Phone
(315) 458-8700
Fax
(315) 701-1075
NPI assigned
May 24, 2005
Last updated
Jul 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F343403-1 NY Primary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X F3601371 NY

Addresses

Primary practice location

792 N Main St Ste 200
North Syracuse, NY 13212

Mailing address

792 N Main St Ste 200
North Syracuse, NY 13212-1644
Phone (315) 458-8700

Other practice location 1

600 E Genesee St
Suite 323
Syracuse, NY 13202-3130
Phone (315) 476-1645

Other practice location 2

4811 Buckley Rd
Liverpool, NY 13088-3676
Phone (315) 457-9966

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)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
343403NYMDPsychiatry Physician
F343403-1NYMDFamily Nurse Practitioner
F3601371NYMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Your Health Your Choice Dietetics and Nutrition PLLC PastSince Jul 29, 2019 Accepting new patients

Organizations & group practices 1

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1063415024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 N MAIN ST STE 200",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132121644",
            "telephone_number": "315-458-8700",
            "fax_number": "315-701-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "792 N MAIN ST STE 200",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "13212",
            "telephone_number": "315-458-8700",
            "fax_number": "315-701-1075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 E Genesee St",
            "address_2": "Suite 323",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132023130",
            "country_code": "US",
            "telephone_number": "315-476-1645",
            "fax_number": "315-476-5640",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4811 Buckley Rd",
            "address_purpose": "LOCATION",
            "city": "Liverpool",
            "state": "NY",
            "postal_code": "130883676",
            "country_code": "US",
            "telephone_number": "315-457-9966",
            "fax_number": "315-457-9854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "ERIN",
        "middle_name": "M",
        "credential": "NP, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F343403-1",
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NY",
            "license": "F3601371",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.