Carlin Borden Vickery, M.D.

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

License

144463 Issued in NY

Practice address

1125 5TH Ave
New York, NY 10128-0143

Phone

(212) 288-9800

Fax

(212) 860-7446

NPI assigned

Aug 30, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740399005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100293852",
            "telephone_number": "212-996-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101280143",
            "telephone_number": "212-288-9800",
            "fax_number": "212-860-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERY",
        "first_name": "CARLIN",
        "middle_name": "BORDEN",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "NY",
            "license": "144463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P621719",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "N27472",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Christine Vicente, CASAC-T
• Pratya Vichetpitayapong, RN
• Monique Vickerie
• Adrienne Vickers, MD
• Selwyn Maurice Vickers, MD
• Sean M Vickery, CASAC-T
• Vicki J Levine M.D.
• A-Rian Vince Victa, RDN.CDN
• Victor Dermatology & Rejuvenation, PC
• Ryan Victor Joseph, MD

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in New York, NY
• Providers in New York, NY by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.