Carol Rae Warfield

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209-000684 Issued in IL

Practice address

512 N Maple St
Effingham, IL 62401-2005

Phone

(217) 347-7030

Fax

(217) 347-7049

NPI assigned

Jun 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Miss Carol Rae Woodard Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1174559413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 NETWORK CENTRE DR",
            "address_2": "SUITE 3",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624014632",
            "telephone_number": "217-347-2707",
            "fax_number": "217-347-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 N MAPLE ST",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012005",
            "telephone_number": "217-347-7030",
            "fax_number": "217-347-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARFIELD",
        "first_name": "CAROL",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-000684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "041112424",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSE",
            "identifier": "209000684",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER CONTROLLED SUBS LICENSE",
            "identifier": "309000228",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "WOODARD",
            "middle_name": "RAE",
            "prefix": "MISS",
            "credential": "APN, FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Effingham, IL
• Providers in Effingham, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.