Mary D Carman, ARNP
Individual provider Active NPI Nurse Practitioner · Midway, KY
NPI 1154322154 · NPPES record last updated Jun 18, 2010
Key facts
- NPI
- 1154322154
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 3277P (KY)
- Practice address
- 129 S Winter St
Midway, KY 40347-1015 - Phone
- (859) 846-4445
- Fax
- (859) 846-4761
- NPI assigned
- Aug 2, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100828000070 | KY | Practitioner - Nurse Practitioner | 4082738935 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3277P | KY | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anderson Family Health Care, PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3277P | KY | Yes |
Addresses
Primary practice location
129 S Winter St
Midway, KY 40347-1015
Mailing address
PO Box 277
Midway, KY 40347-0277
Phone (859) 846-4445
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78004876 | Medicaid | KY |
Other providers in Midway, KY
- Ariel Allman
- Maggie Bush
- Tara Jordan Caldwell
- Capital Family Physicians PSC
- Kim D Clawson
- Cumberland Family Medical Center Inc
- Marshall Allen Dawson Jr.
- Gina Dearth-Pendley
- Eden Physical Therapy, LLC
All providers in Midway, KY · Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.