Individual provider Active NPI

Carol Perva, RN

  • Registered Nurse
  • Kewanee, IL
National Provider Identifier
1255809349
Registry record updated Nov 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041.343047 Issued in IL
Practice address
137 E College St
Kewanee, IL 61443-3703
Phone
(309) 852-4331
Fax
(309) 854-0122
NPI assigned
Nov 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2018

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 041.343047 IL Primary

Addresses

Primary practice location

137 E College St
Kewanee, IL 61443-3703

Mailing address

137 E College St
Kewanee, IL 61443-3703
Phone (309) 852-4331

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

LicenseStateTypeSpecialty
041.343047ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1255809349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 E COLLEGE ST",
            "city": "KEWANEE",
            "state": "IL",
            "postal_code": "614433703",
            "telephone_number": "309-852-4331",
            "fax_number": "309-854-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 E COLLEGE ST",
            "city": "KEWANEE",
            "state": "IL",
            "postal_code": "614433703",
            "telephone_number": "309-852-4331",
            "fax_number": "309-854-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERVA",
        "first_name": "CAROL",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-06",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.343047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kewanee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; 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.