Individual provider Active NPI

Carlin Vicchiarelli

  • Registered Nurse
  • Mentor, OH
National Provider Identifier
1235893298
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN.497864 Issued in OH
Practice address
9083 Mentor Ave
Mentor, OH 44060-6462
Phone
(440) 255-0678
Fax
(440) 255-6348
NPI assigned
Oct 26, 2021
Last updated
Oct 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.497864 OH Primary

Addresses

Primary practice location

9083 Mentor Ave
Mentor, OH 44060-6462

Mailing address

104 Hiram College Dr
Sagamore Hills, OH 44067-2415
Phone (330) 780-7035

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL .us

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
RN.497864OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1235893298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 HIRAM COLLEGE DR",
            "city": "SAGAMORE HILLS",
            "state": "OH",
            "postal_code": "440672415",
            "telephone_number": "330-780-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9083 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440606462",
            "telephone_number": "440-255-0678",
            "fax_number": "440-255-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICCHIARELLI",
        "first_name": "CARLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.497864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": ".us",
            "affiliation": "N",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": ".us",
            "address_1": "9083 Mentor Ave",
            "city": "Mentor",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440606462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.