Carolyn Nicole McCallister, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

37790 Issued in WV

Practice address

332 6TH Ave
South Charleston, WV 25303-1269

Phone

(304) 757-9333

NPI assigned

Apr 17, 2022

Last updated

Apr 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stonerise Home Health Services LLC

  dba Stonerise Home Health

  • Home Health Agency
  • Charleston, WV
  • NPI 1235529595
  NPD (past)

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

{
    "created_epoch": "1650153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650153600000",
    "number": "1356084412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8427 WINFIELD RD",
            "city": "WINFIELD",
            "state": "WV",
            "postal_code": "252137002",
            "telephone_number": "304-356-7486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 6TH AVE",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253031269",
            "telephone_number": "304-757-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCALLISTER",
        "first_name": "CAROLYN",
        "middle_name": "NICOLE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-17",
        "last_updated": "2022-04-17",
        "certification_date": "2022-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WV",
            "license": "37790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon F. Maynard, RD
• Tristan Kendrick Maynard, PHARM.D.
• Barbara Maynor
• Beena Narendra Mazza, MPT
• Connie McCall
• Jessica L McCallister
• Julie N McCallister, MD
• Kandi Michelle Ann McCallister
• Sherry McCallister
• Tiffany McCallister

• Licensed Practical Nurse in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Licensed Practical Nurse in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.