Individual provider Active NPI

Carol Beall, NP

  • Adult Health Nurse Practitioner
  • Bloomington, IN
National Provider Identifier
1508953076
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
71000655A Issued in IN
Practice address
326 S Woodscrest Dr
Bloomington, IN 47401-5314
Phone
(812) 353-3333
Fax
(812) 323-8528
NPI assigned
Oct 6, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 71000655A IN Primary

Addresses

Primary practice location

326 S Woodscrest Dr
Bloomington, IN 47401-5314

Mailing address

3004 Forest Ridge Dr
Bloomington, IN 47401-9639
Phone (812) 824-7164

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
71000655AINMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508953076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 FOREST RIDGE DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474019639",
            "telephone_number": "812-824-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 S WOODSCREST DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015314",
            "telephone_number": "812-353-3333",
            "fax_number": "812-323-8528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEALL",
        "first_name": "CAROL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71000655A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.