Carol G Underwood

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

A01154 Issued in AR

Practice address

1484 W 1St St N
Prescott, AR 71857-3339

Phone

(870) 887-0155

NPI assigned

Aug 24, 2015

Sex

Female

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)

Enrolled

State licenses

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1144697301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1484 W 1ST ST N",
            "city": "PRESCOTT",
            "state": "AR",
            "postal_code": "718573339",
            "telephone_number": "870-887-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1484 W 1ST ST N",
            "city": "PRESCOTT",
            "state": "AR",
            "postal_code": "718573339",
            "telephone_number": "870-887-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "CAROL",
        "middle_name": "G",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AR",
            "license": "A01154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea L Toliver-Smith
• Marsha Juanita Townsend, RN
• Chad Allen Trevillion
• Rebecca A Trevillion
• Kimberly Janet Tye, LPN
• VBNC Ops, Inc.
• Charles A. Vermont, M.D.
• W.Darrel Fain D.D.S. P.a.
• Aubrey Walker, QBHP
• Alicia L Washington

• Gerontology Nurse Practitioner in Prescott, AR
• Providers in Prescott, AR by specialty
• Gerontology Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.