Carrie A Ettenberger

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

91029 Issued in NC

Practice address

20 Page Dr
Pinehurst, NC 28374-8847

Phone

(910) 621-2937

NPI assigned

Nov 2, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Ats of North Carolina, LLC

  • Methadone Clinic
  • Pinehurst, NC
  • NPI 1649310152
  NPD

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1710642129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PAGE DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748847",
            "telephone_number": "607-368-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PAGE DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748847",
            "telephone_number": "910-621-2937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTENBERGER",
        "first_name": "CARRIE",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-02",
        "last_updated": "2021-11-02",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NC",
            "license": "91029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Carrie.ettenberger@ctcprograms.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "20 Page Dr",
            "city": "Pinehurst",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283748847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William Arlan Elman, M.D.
• Eriken LLC
• Claire Silao Esguerra
• Essence of Light
• Stacie R. Estes
• Matthew Ray Eubanks, PA
• Brianne Hendrick Evans, PA-C
• Heather Ann Evans, AU.D.
• Linda Mae Evans, LCSW
• Faith Witt, DDS, PLLC

• Licensed Practical Nurse in Pinehurst, NC
• Providers in Pinehurst, NC by specialty
• Licensed Practical Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.