Individual provider Active NPI

Carolyn A. Castleberry, APRN-CNP

  • Family Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1386210623
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0028094 Issued in OH
Practice address
300 W 10TH Ave
Columbus, OH 43210-1280
Phone
(614) 685-4263
Fax
(614) 685-4768
NPI assigned
May 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0028094 OH Primary

Addresses

Primary practice location

300 W 10TH Ave
Columbus, OH 43210-1280

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 685-4263

Other identifiers 1

IdentifierTypeStateIssuer
0478747MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20220322000396 OH Practitioner - Nurse Practitioner 4688069040 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0028094OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Ohio LLC Family CurrentSince Aug 12, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

199 Graceland Blvd
Columbus, OH 43214
Phone (614) 410-2814

3637 S High St
Columbus, OH 43207
Phone (614) 492-1081

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.

NPI Registry JSON

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1386210623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-685-4263",
            "fax_number": "614-685-4768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101280",
            "telephone_number": "614-685-4263",
            "fax_number": "614-685-4768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTLEBERRY",
        "first_name": "CAROLYN",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-27",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0028094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0478747",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.