Individual provider Active NPI

Carolyn Taraborelli-Baxter, APRN

  • Adult Health Nurse Practitioner
  • Providence, RI
National Provider Identifier
1376133843
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN02511 Issued in RI
Practice address
1085 N Main St
Providence, RI 02904-5719
Phone
(401) 415-4618
Fax
(401) 415-4348
NPI assigned
Jan 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN46584 RI
Nurse Practitioner 363L00000X APRN02511 RI
Gerontology Nurse Practitioner 363LG0600X APRN02511 RI
Adult Health Nurse Practitioner 363LA2200X APRN02511 RI Primary

Addresses

Primary practice location

1085 N Main St
Providence, RI 02904-5719

Mailing address

1085 N Main St
Providence, RI 02904-5719
Phone (401) 415-4618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN46584RIMDRegistered Nurse
APRN02511RIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Mar 2, 2022 Accepting new patients

Locations

270 Bellevue Ave
Newport, RI 02840
Phone (203) 843-2264

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1376133843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045719",
            "telephone_number": "401-415-4618",
            "fax_number": "401-415-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1085 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045719",
            "telephone_number": "401-415-4618",
            "fax_number": "401-415-4348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARABORELLI-BAXTER",
        "first_name": "CAROLYN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "RI",
            "license": "RN46584",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN02511",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "RI",
            "license": "APRN02511",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "RI",
            "license": "APRN02511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.