Carey Ann Headlee, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60069 Issued in CA

Practice address

7920 Frost St Ste 200
San Diego, CA 92123-4289

Phone

(858) 966-8603

NPI assigned

Sep 14, 2010

Last updated

Aug 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Carey Corliss Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1346558251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7920 FROST ST STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234289",
            "telephone_number": "858-966-8603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEADLEE",
        "first_name": "CAREY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA60069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAREY",
            "last_name": "CORLISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Rory Headlong
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• Physician Assistant in San Diego, CA
• Providers in San Diego, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.