Paul Angelo Carbone, FNP-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

470318914 Issued in MI

Practice address

6260 40TH Ave
Hudsonville, MI 49426-8947

Phone

(616) 885-8369

NPI assigned

Feb 7, 2024

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

Enrolled in MI

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Total Extended Care Services PC

  • Physical Medicine & Rehabilitation Physician
  • Englewood, OH
  • NPI 1699522029

  MI, Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1707264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1801650221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6260 40TH AVE",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494268947",
            "telephone_number": "616-885-8369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6260 40TH AVE",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494268947",
            "telephone_number": "616-885-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBONE",
        "first_name": "PAUL",
        "middle_name": "ANGELO",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "470318914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Caldwell
• Joanna Cammenga, O.D.
• Campbell Therapies, LLC
• Ashton Campbell, LPC
• Olivia Campbell, LPC
• Michelle Castillo, COTA-L
• Tashina Marie Cate, RN
• Bethany Chatman, LLC
• Amanda Collins, DPT
• Brian Huston Colvin, PHYSICAL THERAPIST

• Family Medicine Physician in Hudsonville, MI
• Providers in Hudsonville, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.