Individual provider Active NPI

Carol Lynn La Torre, NP

  • Adult Health Nurse Practitioner
  • Statesville, NC
National Provider Identifier
1811291636
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5005033 Issued in NC
Practice address
700 Sullivan Rd
Statesville, NC 28677-3440
Phone
(704) 924-9111
Fax
(704) 883-0452
NPI assigned
Jan 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 5005033 NC Primary

Addresses

Primary practice location

700 Sullivan Rd
Statesville, NC 28677-3440

Mailing address

PO Box 1845
Statesville, NC 28687-1845
Phone (704) 873-4277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20110221000760 NC Practitioner - Nurse Practitioner 8022299288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians

Practice addresses (Care Compare)

700 Sullivan Rd
Statesville, NC 28677-3440
Phone (704) 924-9111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5005033NCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Healthcare, PA CurrentSince Dec 26, 2011 Accepting new patients
Piedmont Healthcare, P.a. CurrentSince Dec 26, 2011 Accepting new patients

Locations

700 Sullivan Rd
Statesville, NC 28677
Phone (704) 924-9111

208 Old Mocksville Rd
Statesville, NC 28625
Phone (704) 838-8215

619 Sullivan Rd
Statesville, NC 28677
Phone (704) 871-0934

650 Signal Hill Drive Ext
Statesville, NC 28625
Phone (704) 873-4277

Organizations & group practices 2

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": "1294444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1811291636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-873-4277",
            "fax_number": "704-978-3549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SULLIVAN RD",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773440",
            "telephone_number": "704-924-9111",
            "fax_number": "704-883-0452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA TORRE",
        "first_name": "CAROL",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-08",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5005033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.