Active NPI
Jaclyn Carricato
- Military Health Care Provider
- North Bend, OR
National Provider Identifier
1528423522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- Practice address
- 2000 Connecticut Ave
North Bend, OR 97459-2300 - Phone
- (631) 291-2498
- NPI assigned
- Dec 18, 2015
- 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 |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | Primary |
Addresses
Primary practice location
2000 Connecticut Ave
North Bend, OR 97459-2300
Mailing address
2000 Connecticut Ave
North Bend, OR 97459-2300
Phone (631) 291-2498
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": "1450396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450396800000",
"number": "1528423522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 CONNECTICUT AVE",
"city": "NORTH BEND",
"state": "OR",
"postal_code": "974592300",
"telephone_number": "631-291-2498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 CONNECTICUT AVE",
"city": "NORTH BEND",
"state": "OR",
"postal_code": "974592300",
"telephone_number": "631-291-2498"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRICATO",
"first_name": "JACLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-18",
"last_updated": "2015-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.