Carrie Smith Nold, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7799 Issued in GA

Practice address

625 Old Peachtree Rd NW
Suwanee, GA 30024-2937

Phone

(770) 682-2362

NPI assigned

Sep 22, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1063795409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 OLD PEACHTREE RD NW",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242937",
            "telephone_number": "770-682-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 OLD PEACHTREE RD NW",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242937",
            "telephone_number": "770-682-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLD",
        "first_name": "CARRIE",
        "middle_name": "SMITH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1681",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.