Carolyn D Concia NP Prof Corp

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

Legal business name

CAROLYN D CONCIA NP PROF CORP

Practice address

2308 NW Stimpson LN
Portland, OR 97229-8562

Phone

(971) 294-0560

NPI assigned

Jul 8, 2019

Organization subpart

No

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

Authorized official

Name

Carolyn D Concia, GNPNPI 1568419091

Title

Owner

Phone

(971) 294-0560

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carolyn Dolores Concia, NP

  • Gerontology Nurse Practitioner
  • Portland, OR
  • NPI 1568419091

  WA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562544000000",
    "number": "1487216669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 NW STIMPSON LN",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972298562",
            "telephone_number": "971-294-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 NW STIMPSON LN",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972298562",
            "telephone_number": "971-294-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLYN D CONCIA NP PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-07-08",
        "status": "A",
        "authorized_official_last_name": "CONCIA",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "971-294-0560",
        "authorized_official_credential": "GNP"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy D Carolan, MD
• Caroleigh Elliott, DC
• Christine Claire Carolino, PHARMD
• Dexter Jay Carolino, DPT
• Carolyn B Yang MD PC
• Elayna Caron, LMT
• Rachel Levie Caron, MD
• Andrew Caroon, DC, MS
• Elyssia Ann Caropreso
• David Norman Carothers, DDS

• Gerontology Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Gerontology Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.