Active NPI
Carol Kay Tharp, MD
- Dermatology Physician
- Winnetka, IL
National Provider Identifier
1811988397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Practice address
- 840 Green Bay Rd
Winnetka, IL 60093-1864 - Phone
- (847) 446-7996
- Fax
- (847) 446-7926
- NPI assigned
- Nov 2, 2005
- 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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | IL | Primary |
Addresses
Primary practice location
840 Green Bay Rd
Winnetka, IL 60093-1864
Mailing address
840 Green Bay Rd
Winnetka, IL 60093-1864
Phone (847) 446-7996
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 3, 2024 through Jun 3, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036048995 | IL | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202342400000",
"number": "1811988397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 GREEN BAY RD",
"city": "WINNETKA",
"state": "IL",
"postal_code": "600931864",
"telephone_number": "847-446-7996",
"fax_number": "847-446-7926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 GREEN BAY RD",
"city": "WINNETKA",
"state": "IL",
"postal_code": "600931864",
"telephone_number": "847-446-7996",
"fax_number": "847-446-7926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THARP",
"first_name": "CAROL",
"middle_name": "KAY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-11-02",
"last_updated": "2008-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winnetka, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.