Carol A Stults, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

28072562A Issued in IN

Practice address

5649 Coventry LN
Fort Wayne, IN 46804-7145

Phone

(260) 436-6565

Fax

(260) 459-1130

NPI assigned

Aug 16, 2011

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 1

Other names 1

• Carol A Springer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344211200000",
    "number": "1205115649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5649 COVENTRY LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047145",
            "telephone_number": "260-436-6565",
            "fax_number": "260-459-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5649 COVENTRY LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047145",
            "telephone_number": "260-436-6565",
            "fax_number": "260-459-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STULTS",
        "first_name": "CAROL",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-16",
        "last_updated": "2012-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "28072562A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201039990",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "SPRINGER",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Valerie L Stucky, NP
• Jeffrey R Studebaker, LMHC, LCSW, LCAC
• Kyla Study
• Jennifer Rebecca Stuff, NP
• Ronald J Stukey, D.O.
• Jeannie Stults, RBT, BS
• Jeremy Royal Stults
• Jessica M Stultz, RBT
• Anthony Stump, PT
• Curtis Dale Stump Jr., PHARMD

• Primary Care Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Primary Care Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; 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.