Carolyn Louise Krenkel, NP

Individual provider Active NPI Nurse Practitioner · Woodlawn, VA

NPI 1295700698 · NPPES record last updated Dec 22, 2015

Key facts

NPI
1295700698
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
0024171506 (VA)
Practice address
5261 Carrollton Pike
Suite B
Woodlawn, VA 24381-3030
Phone
(276) 238-8876
Fax
(276) 238-8886
NPI assigned
Feb 20, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Care Current
since Nov 1, 2021
Accepting new patients
Pain Management Center of Southern Indiana, Inc. Past Accepting new patients
Pain Management Center of Southern Indiana Past Accepting new patients

Locations

4019 W 12600 S
Ste 120
Riverton, UT 84096
Phone (801) 273-0100

9980 S 300 W
Ste 310
Sandy, UT 84070
Phone 8012536886300

2019 E Riverside Dr
Ste A101
St George, UT 84790
Phone (435) 656-1699

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024171506 VA Yes

Addresses

Primary practice location

5261 Carrollton Pike
Suite B
Woodlawn, VA 24381-3030

Mailing address

10900 Nuckols Rd 110
Glen Allen, VA 23060-9246
Phone (804) 396-6412

Other identifiers

IdentifierTypeStateIssuer
261083931OtherTAX ID
C10361OtherGROUP ORGANIZATION PTAN
1295700698MedicaidVA
DN2980OtherGROUP PTAN
Q52983OtherPTAN

Other providers in Woodlawn, VA

All providers in Woodlawn, VA · Nurse Practitioner in Virginia

Sources for this page

Verify at the official NPI Registry.