Carly J McKillop, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

338053 Issued in NY

Practice address

169 Riverside Dr
Lourdes Primary Care Network, Suite 307
Binghamton, NY 13905-4246

Phone

(607) 798-5897

Fax

(607) 798-5093

NPI assigned

Jul 23, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Carly J Zomro Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Our Lady of Lourdes Memorial Hospital Inc.

  • General Acute Care Hospital
  • Binghamton, NY
  • NPI 1629087580
  Medicare reassignment NPD
• Our Lady of Lourdes Memorial Hospital, Inc.

  • Family Medicine Physician
  • Binghamton, NY
  • NPI 1063557189
  NPD
• Our Lady of Lourdes Memorial Hospital, Inc.

  • Specialty Pharmacy
  • Johnson City, NY
  • NPI 1730982596
  NPD
• Twin Tier Pathology Associates, PC

  • Clinical Pathology/Laboratory Medicine Physician
  • Binghamton, NY
  • NPI 1770577470
  NPD
• Cloud Health Medical Group, P.a.

  • Internal Medicine Physician
  • White Plains, NY
  • NPI 1528744935
  NPD (past)

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1215379912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 RIVERSIDE DR",
            "address_2": "LOURDES PRIMARY CARE NETWORK, SUITE 307",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054246",
            "telephone_number": "607-798-5897",
            "fax_number": "607-798-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 RIVERSIDE DR",
            "address_2": "LOURDES PRIMARY CARE NETWORK, SUITE 307",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054246",
            "telephone_number": "607-798-5897",
            "fax_number": "607-798-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKILLOP",
        "first_name": "CARLY",
        "middle_name": "J",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "338053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "ZOMRO",
            "middle_name": "J",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jasmine Mercina McGillick
• Dori Lynn McGowan, OTR/L
• Esther R McGurrin, LCSW-R
• Amanda McIntyre-Silvanic
• Derek McKenna, NP
• Karen McKissick
• Kimberly Bradford McLain, PH.D., LMHC, NCC
• Donya McLaren
• Jessica Lynn McLaughlin
• Kelly M McLaughlin, R.P.A.C.

• Family Nurse Practitioner in Binghamton, NY
• Providers in Binghamton, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.