Active NPI
Carolyn Penharlow
- Family Nurse Practitioner
- Vienna, VA
National Provider Identifier
1699707331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 0024159267
- Practice address
- 337 Maple Ave E
Minuteclinic LLC
Vienna, VA 22180-4717 - Phone
- (866) 389-2727
- Fax
- (401) 652-9787
- NPI assigned
- Jul 6, 2006
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024159267 | VA | Primary |
Addresses
Primary practice location
337 Maple Ave E
Minuteclinic LLC
Vienna, VA 22180-4717
Mailing address
337 Maple Ave E
Vienna, VA 22180-4717
Phone (866) 389-2727
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0024159267 | VA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395273600000",
"number": "1699707331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "337 MAPLE AVE E",
"city": "VIENNA",
"state": "VA",
"postal_code": "221804717",
"telephone_number": "866-389-2727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "337 MAPLE AVE E",
"address_2": "MINUTECLINIC LLC",
"city": "VIENNA",
"state": "VA",
"postal_code": "221804717",
"telephone_number": "866-389-2727",
"fax_number": "401-652-9787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENHARLOW",
"first_name": "CAROLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-06",
"last_updated": "2014-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "VA",
"license": "0024159267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vienna, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.