Tom Carradine, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

95248101 Issued in CA

Practice address

6325 Green Valley Cir
Culver City, CA 90230-7062

Phone

(310) 849-8210

NPI assigned

Jul 29, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Free Carradine Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1558034066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6325 GREEN VALLEY CIR",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902307062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6325 GREEN VALLEY CIR",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902307062",
            "telephone_number": "310-849-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRADINE",
        "first_name": "TOM",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95248101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FREE",
            "last_name": "CARRADINE",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Constance E Carlson, PT
• Ofelia Carmona Gijon
• Nathalie Celeste Carmona
• John A Carnemolla
• Sharon Carpenter
• Jason Julian Carrasco, M.A., LMFT
• Griselda Jimenez Carreon
• Jennifer Carrillo
• Kianna Carrillo
• Leticia Carrillo

• Registered Nurse in Culver City, CA
• Providers in Culver City, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.