Individual provider Active NPI

Carolyn K. Lavender, ARNP

  • Nurse Practitioner
  • St. Petersburg, FL
National Provider Identifier
1346535093
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP1885892 Issued in FL
Practice address
1615 Pasadena Ave. South
Suite 400
St. Petersburg, FL 33707-4505
Phone
(727) 341-1316
Fax
(727) 345-4000
NPI assigned
Jun 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP1885892 FL Primary

Addresses

Primary practice location

1615 Pasadena Ave. South
Suite 400
St. Petersburg, FL 33707-4505

Mailing address

4371 Veronica S Shoemaker Blvd
Attn: Credential Department
Fort Myers, FL 33916-2216
Phone (239) 274-8200

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

State licenses

LicenseStateTypeSpecialty
ARNP1885892FLMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1346535093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 VERONICA S SHOEMAKER BLVD",
            "address_2": "ATTN: CREDENTIAL DEPARTMENT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339162216",
            "telephone_number": "239-274-8200",
            "fax_number": "239-278-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 PASADENA AVE. SOUTH",
            "address_2": "SUITE 400",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337074505",
            "telephone_number": "727-341-1316",
            "fax_number": "727-345-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVENDER",
        "first_name": "CAROLYN",
        "middle_name": "K.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-10",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP1885892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.