Active NPI
Michael Carter, RN
- Registered Nurse
- Bridgeport, CT
National Provider Identifier
1396153193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 57057
- Practice address
- 425 Grant St
Bridgeport, CT 06610-3222 - Phone
- (203) 781-4600
- Fax
- (203) 781-4624
- NPI assigned
- Jul 25, 2014
- Sex
- Male
- 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 | 57057 | CT | Primary |
Addresses
Primary practice location
425 Grant St
Bridgeport, CT 06610-3222
Mailing address
1 Long Wharf Dr
New Haven, CT 06511-5946
Phone (203) 781-4600
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57057 | CT | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493078400000",
"number": "1396153193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 LONG WHARF DR",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065115946",
"telephone_number": "203-781-4600",
"fax_number": "203-781-4624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 GRANT ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066103222",
"telephone_number": "203-781-4600",
"fax_number": "203-781-4624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "MICHAEL",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-25",
"last_updated": "2017-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CT",
"license": "57057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.