Individual provider Active NPI

Marcellous Carter

  • Private Vehicle
  • Locust Grove, VA
National Provider Identifier
1184074718
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Private VehicleTaxonomy code 347C00000X
License
T67397272 Issued in VA
Practice address
35109 Sara CT
Locust Grove, VA 22508-2192
Phone
(202) 360-6060
NPI assigned
Jun 14, 2016
Last updated
Jun 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Private Vehicle 347C00000X T67397272 VA Primary

Addresses

Primary practice location

35109 Sara CT
Locust Grove, VA 22508-2192

Mailing address

35109 Sara CT
Locust Grove, VA 22508-2192
Phone (202) 360-6060

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
T67397272VAMDPrivate Vehicle

NPI Registry JSON

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1184074718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35109 SARA CT",
            "city": "LOCUST GROVE",
            "state": "VA",
            "postal_code": "225082192",
            "telephone_number": "202-360-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35109 SARA CT",
            "city": "LOCUST GROVE",
            "state": "VA",
            "postal_code": "225082192",
            "telephone_number": "202-360-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "MARCELLOUS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "VA",
            "license": "T67397272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Locust Grove, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; 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.