Individual provider Active NPI

Carolyn June Verbanic, CRNP

  • Family Nurse Practitioner
  • Pittsburgh, PA
National Provider Identifier
1114949435
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA05675 Issued in OH
Practice address
1010 Delafield Rd
Pittsburgh, PA 15215-1802
Phone
(412) 822-3000
NPI assigned
Jul 24, 2006
Last updated
Feb 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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 COA05675 OH Primary
Family Nurse Practitioner 363LF0000X TP005634W PA

Addresses

Primary practice location

1010 Delafield Rd
Pittsburgh, PA 15215-1802

Mailing address

1010 Delafield Rd
Pittsburgh, PA 15215-1802
Phone (412) 897-2479

Other practice location 1

17 E Broad St
Newton Falls, OH 44444-1604
Phone (330) 872-3273

Other identifiers 1

IdentifierTypeStateIssuer
0058790MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240905000467 PA Order and Referring Only - Nurse Practitioner 8123009859

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA05675OHMDFamily Nurse Practitioner
TP005634WPAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Kidney Disease & Hypertension, P.C. Past Accepting new patients
Pittsburgh Nephrology Associates, LLC 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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1114949435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 DELAFIELD RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152151802",
            "telephone_number": "412-897-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 DELAFIELD RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152151802",
            "telephone_number": "412-822-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Newton Falls",
            "state": "OH",
            "postal_code": "444441604",
            "country_code": "US",
            "telephone_number": "330-872-3273",
            "fax_number": "330-609-5056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERBANIC",
        "first_name": "CAROLYN",
        "middle_name": "JUNE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA05675",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "TP005634W",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0058790",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.