Individual provider Active NPI

Caroline Armstrong, LVN, ADMINISTRATOR

  • Assisted Living Facility
  • Redlands, CA
National Provider Identifier
1205493566
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
361880724 Issued in CA
Practice address
911 Hartzell Ave
Redlands, CA 92374-2523
Phone
(909) 792-3835
NPI assigned
May 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164X00000X 271315 CA
Respite Care 385H00000X 361880724 CA
Assisted Living Facility 310400000X 361880724 CA Primary

Addresses

Primary practice location

911 Hartzell Ave
Redlands, CA 92374-2523

Mailing address

PO Box 539
Mentone, CA 92359-0539
Phone (909) 806-0049

Other practice location 1

1328 Galaxy Dr
Beaumont, CA 92223-3454
Phone (909) 806-0049

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
271315CAMDLicensed Vocational Nurse
361880724CAMDAssisted Living Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Aa Plus Home Assisted Living Facility CurrentSince Jun 22, 2021 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": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1205493566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 539",
            "city": "MENTONE",
            "state": "CA",
            "postal_code": "923590539",
            "telephone_number": "909-806-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 HARTZELL AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742523",
            "telephone_number": "909-792-3835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1328 Galaxy Dr",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "CA",
            "postal_code": "922233454",
            "country_code": "US",
            "telephone_number": "909-806-0049",
            "fax_number": "951-381-4035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARMSTRONG",
        "first_name": "CAROLINE",
        "credential": "LVN, ADMINISTRATOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-22",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "271315",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "CA",
            "license": "361880724",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "361880724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; 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.