Individual provider Active NPI

Carolyn Marie Machold, CNS,CRNFA,RNFA

  • Medical-Surgical Clinical Nurse Specialist
  • Tucson, AZ
National Provider Identifier
1790885507
Registry record updated May 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Clinical Nurse SpecialistTaxonomy code 364SM0705X
License
026 Issued in AZ
Practice address
1140 E Calle Mariposa
Tucson, AZ 85718-2952
Phone
(520) 318-6039
Fax
(520) 320-0081
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 042232 AZ
Medical-Surgical Registered Nurse 163WM0705X RN040651 AZ
Medical-Surgical Clinical Nurse Specialist 364SM0705X 026 AZ Primary

Addresses

Primary practice location

1140 E Calle Mariposa
Tucson, AZ 85718-2952

Mailing address

PO Box 42123
Tucson, AZ 85733-2123
Phone (520) 318-6039

Other identifiers 2

IdentifierTypeStateIssuer
184995MedicaidAZ
Z60126OtherAZMEDICAREPTAN

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)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
042232AZMDSpecialist
026AZMDMedical-Surgical Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Tucson Vein Institute LLC Specialist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367539200000",
    "number": "1790885507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42123",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857332123",
            "telephone_number": "520-318-6039",
            "fax_number": "520-320-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 E CALLE MARIPOSA",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857182952",
            "telephone_number": "520-318-6039",
            "fax_number": "520-320-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHOLD",
        "first_name": "CAROLYN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CNS,CRNFA,RNFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2013-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "042232",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "AZ",
            "license": "RN040651",
            "primary": false
        },
        {
            "code": "364SM0705X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "AZ",
            "license": "026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184995",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAREPTAN",
            "identifier": "Z60126",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.