Active NPI
Carroll Anne Edick, R.N.
- School Registered Nurse
- Rome, NY
National Provider Identifier
1487925657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Registered Nurse
- License
- 563115-1
- Practice address
- 1001 Ruby St
Rome, NY 13440-2565 - Phone
- (315) 338-5374
- Fax
- (315) 334-7528
- NPI assigned
- Jan 20, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | 563115-1 | NY | Primary |
Addresses
Primary practice location
1001 Ruby St
Rome, NY 13440-2565
Mailing address
1001 Ruby St
Rome, NY 13440-2565
Phone (315) 338-5374
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 |
|---|---|---|---|
| 563115-1 | NY | MD | School Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327017600000",
"number": "1487925657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 RUBY ST",
"city": "ROME",
"state": "NY",
"postal_code": "134402565",
"telephone_number": "315-338-5374",
"fax_number": "315-334-7528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 RUBY ST",
"city": "ROME",
"state": "NY",
"postal_code": "134402565",
"telephone_number": "315-338-5374",
"fax_number": "315-334-7528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDICK",
"first_name": "CARROLL",
"middle_name": "ANNE",
"credential": "R.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-20",
"last_updated": "2012-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, School",
"state": "NY",
"license": "563115-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rome, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 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.