Individual provider Active NPI

Carolyn Hollins

  • Licensed Practical Nurse
  • Cleveland HTS, OH
National Provider Identifier
1649526112
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN.148103-M-IV Issued in OH
Practice address
3112 E Derbyshire Rd
Cleveland HTS, OH 44118-2729
Phone
(216) 773-2250
NPI assigned
Aug 1, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN.148103-M-IV OH Primary

Addresses

Primary practice location

3112 E Derbyshire Rd
Cleveland HTS, OH 44118-2729

Mailing address

3112 E Derbyshire Rd
Cleveland HTS, OH 44118-2729
Phone (216) 773-2250

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

State licenses

LicenseStateTypeSpecialty
PN.148103-M-IVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1649526112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 E DERBYSHIRE RD",
            "city": "CLEVELAND HTS",
            "state": "OH",
            "postal_code": "441182729",
            "telephone_number": "216-773-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3112 E DERBYSHIRE RD",
            "city": "CLEVELAND HTS",
            "state": "OH",
            "postal_code": "441182729",
            "telephone_number": "216-773-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLINS",
        "first_name": "CAROLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-01",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN.148103-M-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland HTS, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; 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.