Individual provider Active NPI

Carla Walcott, LPN

  • Nursing Care Agency
  • Willoughby, OH
National Provider Identifier
1841024759
Registry record updated Sep 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
186063 Issued in OH
Practice address
34350 Ridge Rd # D-11
Willoughby, OH 44094-3088
Phone
(216) 571-7919
NPI assigned
Sep 2, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X 186063 OH Primary

Addresses

Primary practice location

34350 Ridge Rd # D-11
Willoughby, OH 44094-3088

Mailing address

34350 Ridge Rd # D-11
Willoughby, OH 44094-3088
Phone (216) 571-7919

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
186063OHMDNursing Care Agency

NPI Registry JSON

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

{
    "created_epoch": "1725235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725235200000",
    "number": "1841024759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34350 RIDGE RD # D-11",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440943088",
            "telephone_number": "216-571-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34350 RIDGE RD # D-11",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440943088",
            "telephone_number": "216-571-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALCOTT",
        "first_name": "CARLA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-02",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "OH",
            "license": "186063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2024; 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.