Derrek Carter Sr., LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

303122-31 Issued in WI

Practice address

8027 W Beckett Ave
Milwaukee, WI 53218-4626

Phone

(414) 202-1974

NPI assigned

Jan 12, 2017

Last updated

Jan 12, 2017By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Dream Adult Family Homes LLC

  • Adult Care Home Facility
  • Milwaukee, WI
  • NPI 1902342058
  NPD (past) Authorized official

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1558807735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8027 W BECKETT AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532184626",
            "telephone_number": "414-202-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8027 W BECKETT AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532184626",
            "telephone_number": "414-202-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "DERREK",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "303122-31",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandy Carter, CNA
• Christina Carter
• Crystal D Carter, MSW, LCSW
• Deja Carter, LCSW
• Dennis B Carter Sr.
• Diamond Carter
• Dominic Carter
• Elise Carter, PHARMD
• Frances Abigail Carter
• Francine Carter

• Licensed Practical Nurse in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; 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.