Carol J Borg, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R024086 Issued in SD

Practice address

350 14TH Ave
Skagway, AK 99840-0537

Phone

(907) 983-2255

Fax

(907) 983-2793

NPI assigned

May 19, 2006

Sex

Female

Sole proprietor

No

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.

• Eastern Aleutian Tribes, Inc

  • Community Health Clinic/Center
  • Adak, AK
  • NPI 1285796094

  AK

  Medicare reassignment NPD
• Eastern Aleutian Tribes, Inc

  • Clinic/Center
  • Sand Point, AK
  • NPI 1346662608
  NPD
• Eastern Aleutian Tribes, Inc

  • Community Health Clinic/Center
  • King Cove, AK
  • NPI 1649332446
  NPD (past)
• Iliuliuk Family &Health Services, Inc.

  • Community/Retail Pharmacy
  • Unalaska, AK
  • NPI 1760340905
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 4, 2011.

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312416000000",
    "number": "1356394282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 537",
            "city": "SKAGWAY",
            "state": "AK",
            "postal_code": "998400537",
            "telephone_number": "907-983-2255",
            "fax_number": "907-983-2793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 14TH AVE",
            "city": "SKAGWAY",
            "state": "AK",
            "postal_code": "998400537",
            "telephone_number": "907-983-2255",
            "fax_number": "907-983-2793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORG",
        "first_name": "CAROL",
        "middle_name": "J",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2011-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "R024086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "3475",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6825703",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0019",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "0004772",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "0004792",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "9239542",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00352245",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6825704",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marjorie Ackerman
• Courtney Elizabeth Brisson
• Brittany Nicole Cahalan, FNP
• Conor Daniel Cahalan, PA-C
• Klondy Karina Canales, RMA
• Catholic Community Service

• All providers in Skagway, AK
• Nurse Practitioner in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.