Jorge Stuart Carrillo, DNP - FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN2334224 Issued in MA

Practice address

54 New Bridge St
West Springfield, MA 01089-4211

Phone

(413) 335-9948

NPI assigned

Nov 4, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1104649649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 234",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010900234",
            "telephone_number": "413-335-9948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 NEW BRIDGE ST",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010894211",
            "telephone_number": "413-335-9948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "JORGE",
        "middle_name": "STUART",
        "credential": "DNP - FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2334224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Laura O Carson, PT
• Kristina Cartier, DPT
• Talissa Casal

• Family Nurse Practitioner in West Springfield, MA
• Providers in West Springfield, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.