Active NPI
Alice Carroll
- Registered Nurse
- Centralia, WA
National Provider Identifier
1780086603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN00163862
- Practice address
- 2428 W Reynolds Ave
Centralia, WA 98531-4554 - Phone
- (360) 330-9444
- Fax
- (360) 623-1117
- NPI assigned
- Sep 23, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN00163862 | WA | Primary |
Addresses
Primary practice location
2428 W Reynolds Ave
Centralia, WA 98531-4554
Mailing address
3106 Vista Verde LN SW
Olympia, WA 98512-1448
Phone (406) 370-0616
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN00163862 | WA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411430400000",
"number": "1780086603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3106 VISTA VERDE LN SW",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985121448",
"telephone_number": "406-370-0616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2428 W REYNOLDS AVE",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985314554",
"telephone_number": "360-330-9444",
"fax_number": "360-623-1117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "ALICE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-23",
"last_updated": "2014-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WA",
"license": "RN00163862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centralia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.