Individual provider Active NPI

Nancy Apel Carroll, N.P.

  • Obstetrics & Gynecology Nurse Practitioner
  • South Portland, ME
National Provider Identifier
1689664831
Registry record updated Nov 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
AP081710 Issued in ME
Practice address
778 Main St
Suite 2
South Portland, ME 04106-5447
Phone
(207) 775-1255
Fax
(207) 775-1299
NPI assigned
Oct 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X AP081710 ME Primary

Addresses

Primary practice location

778 Main St
Suite 2
South Portland, ME 04106-5447

Mailing address

39 Wallace Ave
South Portland, ME 04106-6143
Phone (207) 761-0650

Other identifiers 2

IdentifierTypeStateIssuer
30346876MedicaidNH
297340099MedicaidME

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP081710MEMDObstetrics & Gynecology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257206400000",
    "number": "1689664831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 WALLACE AVE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066143",
            "telephone_number": "207-761-0650",
            "fax_number": "207-761-8198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "778 MAIN ST",
            "address_2": "SUITE 2",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041065447",
            "telephone_number": "207-775-1255",
            "fax_number": "207-775-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "NANCY",
        "middle_name": "APEL",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2009-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "ME",
            "license": "AP081710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30346876",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297340099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2009; 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.