Caroline Theresa Cormier, APRN

Key facts

NPI

1316969488

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

ARNP2927022 (FL)

Practice address

1142 7TH St N
Saint Petersburg, FL 33701-1506

Phone

(727) 898-1105

NPI assigned

Jul 24, 2006

Sex

Female

Sole proprietor

Yes

Organizations & group practices 2

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.

• Advanced Wound Systems LLC Durable Medical Equipment & Medical Supplies · St Petersburg, FL · NPI 1508054271
  NPD (past)
• Nautilus Health Care Group, LLC Undersea and Hyperbaric Medicine (Preventive Medicine) Physician · Kokomo, IN · NPI 1013234699
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 29, 2020.

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1316969488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1142 7TH ST N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337011506",
            "telephone_number": "727-898-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORMIER",
        "first_name": "CAROLINE",
        "middle_name": "THERESA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP2927022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305651100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Saint Petersburg, FL · Family Nurse Practitioner in Florida