Individual provider Active NPI

Kimyata A Carter

  • Case Management Registered Nurse
  • San Jose, CA
National Provider Identifier
1710823893
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
95361941 Issued in CA
Practice address
120 N Willard Ave
San Jose, CA 95126-2815
Phone
(559) 469-3946
NPI assigned
Apr 28, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WC0400X 95361941 CA Primary

Addresses

Primary practice location

120 N Willard Ave
San Jose, CA 95126-2815

Mailing address

120 N Willard Ave
San Jose, CA 95126-2815
Phone (559) 469-3946

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
95361941CAMDCase Management Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1777334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1710823893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N WILLARD AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262815",
            "telephone_number": "559-469-3946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N WILLARD AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262815",
            "telephone_number": "559-469-3946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "KIMYATA",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-28",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Case Management",
            "state": "CA",
            "license": "95361941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; 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.