Individual provider Active NPI

Kiley Carbone

  • Pediatric Nurse Practitioner
  • Norwalk, CT
National Provider Identifier
1508586322
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
10932 Issued in CT
Practice address
69 East Ave
Norwalk, CT 06851-4904
Phone
(203) 229-2000
NPI assigned
Aug 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 10932 CT Primary

Addresses

Primary practice location

69 East Ave
Norwalk, CT 06851-4904

Mailing address

1 N Water St Unit 415
Norwalk, CT 06854-2297
Phone (908) 894-0588

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10932CTMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Advanced Pediatrics, P.C Pediatrics PastSince Sep 4, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kcarbone@tcfap.pcc-direct.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1508586322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 N WATER ST UNIT 415",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068542297",
            "telephone_number": "908-894-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 EAST AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068514904",
            "telephone_number": "203-229-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBONE",
        "first_name": "KILEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "10932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.