Individual provider Active NPI

Caroline Elaine Wilbon, CERTIFIED NURSE ASSI

  • Home Health Agency
  • Ada, MI
National Provider Identifier
1487406435
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Practice address
6749 Fulton St E Ste a
Ada, MI 49301-8102
Phone
(866) 878-0117
NPI assigned
Apr 3, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

6749 Fulton St E Ste a
Ada, MI 49301-8102

Mailing address

3920 Courtyard PL SE
Grand Rapids, MI 49546-7631
Phone (616) 550-2455

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

NPI Registry JSON

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1487406435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 COURTYARD PL SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467631",
            "telephone_number": "616-550-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6749 FULTON ST E STE A",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493018102",
            "telephone_number": "866-878-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBON",
        "first_name": "CAROLINE",
        "middle_name": "ELAINE",
        "credential": "CERTIFIED NURSE ASSI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ada, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.

Verify at the official NPI Registry.