Vidmar Ivan Carrillo Guzman

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

LG-0013919 Issued in DE

Practice address

21444 Carmean Way
Georgetown, DE 19947-4572

Phone

(302) 855-1233

Fax

(302) 654-1061

NPI assigned

Jun 4, 2026

Last updated

Jun 4, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1780531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1780517375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21444 CARMEAN WAY",
            "city": "GEORGETOWN",
            "state": "DE",
            "postal_code": "199474572",
            "telephone_number": "302-855-1233",
            "fax_number": "302-654-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21444 CARMEAN WAY",
            "city": "GEORGETOWN",
            "state": "DE",
            "postal_code": "199474572",
            "telephone_number": "302-855-1233",
            "fax_number": "302-654-1061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 W Clarke Ave Ste 1001",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "DE",
            "postal_code": "199631849",
            "country_code": "US",
            "telephone_number": "302-855-1233",
            "fax_number": "302-654-1061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRILLO GUZMAN",
        "first_name": "VIDMAR",
        "middle_name": "IVAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-04",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0013919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lacy Leigh Burleson Almeida, PMHNP
• Jessica Butler, CADC
• Lisa Ann Butterworth, CRNM
• Jennifer Gick Callard, MSN, APRN, FNP-C
• Cardiac Care, LLC
• Frank Cassidy
• Maria Carmen Castillo, MSW
• Anne M Caswell, MD
• Cheer, Inc. (Sand Hill Adult Day Program)
• Claire Chianese, APRN

• Family Nurse Practitioner in Georgetown, DE
• Providers in Georgetown, DE by specialty
• Family Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.