Individual provider Active NPI

Carol M Bertram, REGISTERED NURSE

  • Registered Nurse
  • White Plains, NY
National Provider Identifier
1144746256
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
477915-1 Issued in NY
Practice address
17 Granada Cres Apt 17-4
White Plains, NY 10603-1251
Phone
(914) 441-9521
NPI assigned
Aug 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 477915-1 NY Primary

Addresses

Primary practice location

17 Granada Cres Apt 17-4
White Plains, NY 10603-1251

Mailing address

17 Granada Cres Apt 17-4
White Plains, NY 10603-1251
Phone (914) 441-9521

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

State licenses

LicenseStateTypeSpecialty
477915-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1144746256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 GRANADA CRES APT 17-4",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106031251",
            "telephone_number": "914-441-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 GRANADA CRES APT 17-4",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106031251",
            "telephone_number": "914-441-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTRAM",
        "first_name": "CAROL",
        "middle_name": "M",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "477915-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.