Active NPI
Carol Lee Ickes
- Registered Nurse
- Bedford, PA
National Provider Identifier
1356806863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN505244L
- Practice address
- 1243 Shed Rd
Bedford, PA 15522-8584 - Phone
- (814) 623-5166
- NPI assigned
- Feb 8, 2019
- Last updated
- Feb 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN505244L | PA | Primary |
Addresses
Primary practice location
1243 Shed Rd
Bedford, PA 15522-8584
Mailing address
1243 Shed Rd
Bedford, PA 15522-8584
Phone (814) 623-5166
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN505244L | Other | PA | LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN505244L | PA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549584000000",
"number": "1356806863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1243 SHED RD",
"city": "BEDFORD",
"state": "PA",
"postal_code": "155228584",
"telephone_number": "814-623-5166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1243 SHED RD",
"city": "BEDFORD",
"state": "PA",
"postal_code": "155228584",
"telephone_number": "814-623-5166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ICKES",
"first_name": "CAROL",
"middle_name": "LEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-08",
"last_updated": "2019-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "PA",
"license": "RN505244L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "RN505244L",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bedford, PA
- Hyndman Area Health Center, Inc (HAHC Inc Behavioral Health)
- Hyndman Area Health Center, Inc (Bedford Family Pharmacy)
- Hyndman Area Health Center, Inc. (Bedford Family Health Center)
- Essam Naguib Ibrahim, D.M.D.
- Ickes Drug Store
- Robyn Faith Isgan, DPT
- Shaylee Breanne Jackson
- Melinda Sue Jacobs, LSW
- Janidlo Optometry PC
- Heather Kerr Janidlo, OD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.