Active NPI
Carolyn Nelson, CNA,CMT, CMI, CASL
- Home Health Aide
- Longview, TX
National Provider Identifier
1194131631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- NA00661294
- Practice address
- 1803 S Green St
Longview, TX 75602-3311 - Phone
- (903) 234-0003
- NPI assigned
- Jul 4, 2014
- 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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | NA00661294 | TX | Primary |
Addresses
Primary practice location
1803 S Green St
Longview, TX 75602-3311
Mailing address
1803 S Green St
Longview, TX 75602-3311
Phone (903) 234-0003
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
| License | State | Type | Specialty |
|---|---|---|---|
| NA00661294 | TX | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404432000000",
"number": "1194131631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1803 S GREEN ST",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756023311",
"telephone_number": "903-234-0003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1803 S GREEN ST",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756023311",
"telephone_number": "903-234-0003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "CAROLYN",
"credential": "CNA,CMT, CMI, CASL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-04",
"last_updated": "2014-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "TX",
"license": "NA00661294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.