Organization Active NPI

Carolyn M. Carey, MD, PA

Doing business as Center for Pediatric Neurosurgery & Neuroscience

  • Neurological Surgery Physician
  • Fort Myers, FL
National Provider Identifier
1336340934
Registry record updated Apr 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
CAROLYN M. CAREY, MD, PA
Doing business as
Center for Pediatric Neurosurgery & Neuroscience
Practice address
4550 Colonial Blvd
Fort Myers, FL 33912-1017
Phone
(727) 767-8181
Fax
(727) 767-8030
NPI assigned
May 30, 2007
Last updated
Apr 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christine Hancock
Title
Administrator
Phone
(727) 767-3808

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X NU Primary
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X NU

Addresses

Primary practice location

4550 Colonial Blvd
Fort Myers, FL 33912-1017

Mailing address

601 5TH St S
Suite 511
St Petersburg, FL 33701-4804
Phone (727) 767-8181

Other identifiers 1

IdentifierTypeStateIssuer
273786802MedicaidFL

Other names 1

  • Center for Pediatric Neurosurgery & Neuroscience Doing business as

National Provider Directory

National Provider Directory

Locations

4550 Colonial Blvd
Fort Myers, FL 33966
Phone (239) 931-5700

601 5th St S
Ste 511
St Petersburg, FL 33701

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302566400000",
    "number": "1336340934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 5TH ST S",
            "address_2": "SUITE 511",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014804",
            "telephone_number": "727-767-8181",
            "fax_number": "727-767-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121017",
            "telephone_number": "727-767-8181",
            "fax_number": "727-767-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLYN M. CAREY, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2011-04-12",
        "status": "A",
        "authorized_official_last_name": "HANCOCK",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "727-767-3808"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273786802",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Pediatric Neurosurgery & Neuroscience",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; 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.