Individual provider Active NPI

Julie Carlock, RNFA

  • Registered Nurse First Assistant
  • Fresno, CA
National Provider Identifier
1174910020
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
612074 Issued in CA
Practice address
205 E River Park Cir
Fresno, CA 93720-1571
Phone
(559) 261-4500
Fax
(559) 224-1825
NPI assigned
Apr 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 612074 CA Primary

Addresses

Primary practice location

205 E River Park Cir
Fresno, CA 93720-1571

Mailing address

PO Box 28947
Fresno, CA 93729-8947
Phone (559) 261-4500

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
612074CAMDRegistered Nurse First Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Laparoscopic Surgery Associates Medical Group Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1174910020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28947",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937298947",
            "telephone_number": "559-261-4500",
            "fax_number": "559-224-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E RIVER PARK CIR",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937201571",
            "telephone_number": "559-261-4500",
            "fax_number": "559-224-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLOCK",
        "first_name": "JULIE",
        "name_prefix": "Dr.",
        "credential": "RNFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-17",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "CA",
            "license": "612074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2015; 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.