Active NPI
Sandra Vanessa Carrillo
- Registered Nurse
- Baltimore, MD
National Provider Identifier
1427892496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R191831
- Practice address
- 1501 S Clinton St
Baltimore, MD 21224-5730 - Phone
- (443) 223-1046
- NPI assigned
- Jun 24, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R191831 | MD | Primary |
Addresses
Primary practice location
1501 S Clinton St
Baltimore, MD 21224-5730
Mailing address
533 W Central Ave
Davidsonville, MD 21035-1942
Other practice location 1
533 W Central Ave
Davidsonville, MD 21035-1942
Phone (443) 223-1046
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R191831 | MD | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719187200000",
"number": "1427892496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "533 W CENTRAL AVE",
"city": "DAVIDSONVILLE",
"state": "MD",
"postal_code": "210351942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 S CLINTON ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212245730",
"telephone_number": "443-223-1046"
}
],
"practiceLocations": [
{
"address_1": "533 W Central Ave",
"address_purpose": "LOCATION",
"city": "Davidsonville",
"state": "MD",
"postal_code": "210351942",
"country_code": "US",
"telephone_number": "443-223-1046",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARRILLO",
"first_name": "SANDRA",
"middle_name": "VANESSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-24",
"last_updated": "2024-06-24",
"certification_date": "2024-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MD",
"license": "R191831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.