Individual provider Active NPI

Carol Arlett Mayott

  • Specialist
  • Rego Park, NY
National Provider Identifier
1770845380
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1271520 Issued in NY
Practice address
9777 Queens Blvd
Rego Park, NY 11374-3335
Phone
(718) 830-9274
NPI assigned
Jun 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1271520 NY Primary

Addresses

Primary practice location

9777 Queens Blvd
Rego Park, NY 11374-3335

Mailing address

895 Eisenhower Dr
West Hempstead, NY 11552-3617
Phone (718) 404-7314

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
1271520NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1339286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1770845380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 EISENHOWER DR",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115523617",
            "telephone_number": "718-404-7314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9777 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743335",
            "telephone_number": "718-830-9274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYOTT",
        "first_name": "CAROL",
        "middle_name": "ARLETT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-10",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1271520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; 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.