Individual provider Active NPI

Carol Ann-Marie Noell, PA-C

  • Medical Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1821167065
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9102064 Issued in FL
Practice address
1400 Bishop Estates Rd
Jacksonville, FL 32259-4244
Phone
(904) 287-2794
Fax
(904) 287-5362
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9102064 FL Primary

Addresses

Primary practice location

1400 Bishop Estates Rd
Jacksonville, FL 32259-4244

Mailing address

1400 Bishop Estates Rd
Jacksonville, FL 32259-4244
Phone (904) 287-2794

Other names 1

  • Carol N Sims Former name

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9102064FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc Past Accepting new patients
Fruit Cove Family Medicine P a Past Accepting new patients
Baptist Primary Care Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: carol.noell.2@8967.direct.athenahealth.com

Organizations & group practices 3

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1821167065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 BISHOP ESTATES RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322594244",
            "telephone_number": "904-287-2794",
            "fax_number": "904-287-5362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BISHOP ESTATES RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322594244",
            "telephone_number": "904-287-2794",
            "fax_number": "904-287-5362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOELL",
        "first_name": "CAROL",
        "middle_name": "ANN-MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "SIMS",
            "middle_name": "N",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; 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.