Active NPI
Carrie Hines, NP
- Family Nurse Practitioner
- Bloomington, IN
National Provider Identifier
1386877413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71003027A
- Practice address
- 4444 W State Road 46
Bloomington, IN 47404-9691 - Phone
- (812) 876-2915
- NPI assigned
- Aug 24, 2009
- Last updated
- Oct 11, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 28137521A | IN | |
| Family Nurse Practitioner | 363LF0000X | 71003027A | IN | Primary |
Addresses
Primary practice location
4444 W State Road 46
Bloomington, IN 47404-9691
Mailing address
437 W Main St
Worthington, IN 47471-1524
Phone (812) 227-0382
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28137521A | IN | MD | Family Nurse Practitioner |
| 71003027A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minuteclinic Diagnostics of Indiana, LLC | Family | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Nurse Practitioner
- Zionsville, IN
- NPI 1932171634
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349913600000",
"number": "1386877413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "437 W MAIN ST",
"city": "WORTHINGTON",
"state": "IN",
"postal_code": "474711524",
"telephone_number": "812-227-0382",
"fax_number": "812-585-6097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4444 W STATE ROAD 46",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474049691",
"telephone_number": "812-876-2915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HINES",
"first_name": "CARRIE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-24",
"last_updated": "2012-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "28137521A",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71003027A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.