Active NPI
Evette Nicole Carroll, RN
- Registered Nurse
- South Euclid, OH
National Provider Identifier
1245463744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN.356195-
- Practice address
- 1335 Sheffield Rd
South Euclid, OH 44121-3649 - Phone
- (216) 375-9868
- NPI assigned
- Aug 31, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | PN. 130245 | OH | |
| Registered Nurse | 163W00000X | RN.356195- | OH | Primary |
Addresses
Primary practice location
1335 Sheffield Rd
South Euclid, OH 44121-3649
Mailing address
1335 Sheffield Rd
South Euclid, OH 44121-3649
Phone (216) 375-9868
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN.356195- | OH | MD | Registered Nurse |
| PN. 130245 | OH | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283558400000",
"number": "1245463744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1335 SHEFFIELD RD",
"city": "SOUTH EUCLID",
"state": "OH",
"postal_code": "441213649",
"telephone_number": "216-375-9868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1335 SHEFFIELD RD",
"city": "SOUTH EUCLID",
"state": "OH",
"postal_code": "441213649",
"telephone_number": "216-375-9868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "EVETTE",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-31",
"last_updated": "2010-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "OH",
"license": "PN. 130245",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "RN.356195-",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Euclid, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.