Individual provider Active NPI

Emily Carr, PA

  • Surgical Physician Assistant
  • Wellington, FL
National Provider Identifier
1164932257
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9110715 Issued in FL
Practice address
1447 Medical Park Blvd Ste 101
Wellington, FL 33414-3164
Phone
(561) 844-0120
NPI assigned
Oct 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9110715 FL Primary

Addresses

Primary practice location

1447 Medical Park Blvd Ste 101
Wellington, FL 33414-3164

Mailing address

1447 Medical Park Blvd Ste 101
Wellington, FL 33414-3164
Phone (561) 844-0120

Other practice location 1

4848 Coconut Creek Pkwy
Coconut Creek, FL 33063-3904
Phone (561) 844-0120

Other practice location 2

8501 SW 124th Ave Ste 207
Miami, FL 33183-4633
Phone (561) 844-0120

Other practice location 3

4600 Linton Blvd Ste 250
Delray Beach, FL 33445-6600
Phone (561) 844-0120

Other identifiers 1

IdentifierTypeStateIssuer
PA9110715OtherFLPA LICENSE

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9110715FLMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1164932257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 MEDICAL PARK BLVD STE 101",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143164",
            "telephone_number": "561-844-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1447 MEDICAL PARK BLVD STE 101",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143164",
            "telephone_number": "561-844-0120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4848 Coconut Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Coconut Creek",
            "state": "FL",
            "postal_code": "330633904",
            "country_code": "US",
            "telephone_number": "561-844-0120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8501 SW 124th Ave Ste 207",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331834633",
            "country_code": "US",
            "telephone_number": "561-844-0120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4600 Linton Blvd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Delray Beach",
            "state": "FL",
            "postal_code": "334456600",
            "country_code": "US",
            "telephone_number": "561-844-0120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARR",
        "first_name": "EMILY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9110715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA9110715",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.