Individual provider Active NPI

Carol Anne Lim, GNP

  • Gerontology Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1710979190
Registry record updated Jan 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
469377 Issued in CA
Practice address
1333 Bush St
San Francisco, CA 94109-5611
Phone
(415) 292-8888
Fax
(415) 292-8845
NPI assigned
Aug 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 469377 CA Primary

Addresses

Primary practice location

1333 Bush St
San Francisco, CA 94109-5611

Mailing address

251 Dantley Way
Walnut Creek, CA 94598-1804
Phone (925) 945-0497

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150623001327 CA Order and Referring Only - Nurse Practitioner 6406167030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
469377CAMDGerontology Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: clim323693@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296086400000",
    "number": "1710979190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 DANTLEY WAY",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945981804",
            "telephone_number": "925-945-0497",
            "fax_number": "415-292-8845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 BUSH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941095611",
            "telephone_number": "415-292-8888",
            "fax_number": "415-292-8845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "CAROL",
        "middle_name": "ANNE",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2011-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "469377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.