Active NPI
Carrie Causey Eley, N.P.
- Family Nurse Practitioner
- Corona, CA
National Provider Identifier
1376743559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 216617
- Practice address
- 16756 Chino Corona Rd
Corona, CA 92880-9508 - Phone
- (909) 597-1771
- Fax
- (909) 606-4925
- NPI assigned
- Jul 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 216617 | CA | Primary |
Addresses
Primary practice location
16756 Chino Corona Rd
Corona, CA 92880-9508
Mailing address
780 Atchison St
Colton, CA 92324-6316
Phone (909) 824-6102
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 216617 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corrections and Rehabilitation-Headquarters | Past | Accepting new patients | |
| State of California | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pharmacy
- Corona, CA
- NPI 1578199741
-
- Psychiatric Hospital
- Corona, CA
- NPI 1366783169
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185321600000",
"number": "1376743559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "780 ATCHISON ST",
"city": "COLTON",
"state": "CA",
"postal_code": "923246316",
"telephone_number": "909-824-6102",
"fax_number": "909-423-0362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16756 CHINO CORONA RD",
"city": "CORONA",
"state": "CA",
"postal_code": "928809508",
"telephone_number": "909-597-1771",
"fax_number": "909-606-4925"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELEY",
"first_name": "CARRIE",
"middle_name": "CAUSEY",
"name_prefix": "Ms.",
"credential": "N.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-25",
"last_updated": "2007-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "216617",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Corona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.