Active NPI
Carol A Thiel, NP
- Nurse Practitioner
- Rochester, NY
National Provider Identifier
1275562191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 330314
- Practice address
- 777 Clinton Ave S
Rochester, NY 14620-1401 - Phone
- (585) 279-4700
- Fax
- (585) 279-4705
- NPI assigned
- Jul 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 330314 | NY | Primary |
Addresses
Primary practice location
777 Clinton Ave S
Rochester, NY 14620-1401
Mailing address
777 Clinton Ave S
Rochester, NY 14620-1401
Phone (585) 279-4700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P019330314 | Other | NY | BLUE CHOICE |
| NP0404 | Other | NY | PREFERRED CARE |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 330314 | NY | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185148800000",
"number": "1275562191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 CLINTON AVE S",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146201401",
"telephone_number": "585-279-4700",
"fax_number": "585-279-4705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 CLINTON AVE S",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146201401",
"telephone_number": "585-279-4700",
"fax_number": "585-279-4705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIEL",
"first_name": "CAROL",
"middle_name": "A",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-02",
"last_updated": "2007-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NY",
"license": "330314",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE",
"identifier": "P019330314",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "NP0404",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.