Individual provider Active NPI

Maura Carroll, RN

  • Maternal Newborn Registered Nurse
  • Riverhead, NY
National Provider Identifier
1073228383
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal Newborn Registered NurseTaxonomy code 163WM0102X
License
328225-01 Issued in NY
Practice address
26 Pier Ave
Riverhead, NY 11901-5409
Phone
(631) 235-6065
NPI assigned
Jan 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal Newborn Registered Nurse 163WM0102X 328225-01 NY Primary

Addresses

Primary practice location

26 Pier Ave
Riverhead, NY 11901-5409

Mailing address

26 Pier Ave
Riverhead, NY 11901-5409
Phone (631) 235-6065

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
328225-01NYMDMaternal Newborn Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1674172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1073228383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 PIER AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119015409",
            "telephone_number": "631-235-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 PIER AVE",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119015409",
            "telephone_number": "631-235-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MAURA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-20",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "NY",
            "license": "328225-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.