Individual provider Active NPI

Carolyn Louise Porter-Rose, R.N.

  • Registered Nurse
  • Riverside, CA
National Provider Identifier
1326248998
Registry record updated Jul 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
290227 Issued in NY
Practice address
9990 County Farm Rd Ste 6
Riverside, CA 92503-3542
Phone
(951) 358-7380
NPI assigned
Jul 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2007

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 290227 NY Primary

Addresses

Primary practice location

9990 County Farm Rd Ste 6
Riverside, CA 92503-3542

Mailing address

9990 County Farm Rd Ste 6
Riverside, CA 92503-3542
Phone (951) 358-7380

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
290227NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside Department of Mental Health Past Accepting new patients
County of Riverside Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1326248998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9990 COUNTY FARM RD STE 6",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033542",
            "telephone_number": "951-358-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9990 COUNTY FARM RD STE 6",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033542",
            "telephone_number": "951-358-7380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER-ROSE",
        "first_name": "CAROLYN",
        "middle_name": "LOUISE",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "290227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

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.

Verify at the official NPI Registry.