Active NPI
Carrie Lynne Davis, RN BSN CDE
- Health Educator
- Roanoke Rapids, NC
National Provider Identifier
1174823538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- License
- 2042-0105
- Practice address
- 210 Smith Church Rd
Roanoke Rapids, NC 27870-4942 - Phone
- (252) 535-8276
- Fax
- (252) 535-8778
- NPI assigned
- Nov 1, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | 2042-0105 | NC | Primary |
Addresses
Primary practice location
210 Smith Church Rd
Roanoke Rapids, NC 27870-4942
Mailing address
210 Smith Church Rd
Roanoke Rapids, NC 27870-4942
Phone (252) 535-8276
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3400151 | Medicaid | NC |
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
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2042-0105 | NC | MD | Health Educator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288569600000",
"number": "1174823538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 SMITH CHURCH RD",
"city": "ROANOKE RAPIDS",
"state": "NC",
"postal_code": "278704942",
"telephone_number": "252-535-8276",
"fax_number": "252-535-8778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 SMITH CHURCH RD",
"city": "ROANOKE RAPIDS",
"state": "NC",
"postal_code": "278704942",
"telephone_number": "252-535-8276",
"fax_number": "252-535-8778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "CARRIE",
"middle_name": "LYNNE",
"name_prefix": "Mrs.",
"credential": "RN BSN CDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-01",
"last_updated": "2010-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "NC",
"license": "2042-0105",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3400151",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roanoke Rapids, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.