Individual provider Active NPI

Bettyann Carlies

  • Licensed Practical Nurse
  • Philadelphia, PA
National Provider Identifier
1851218093
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN269771 Issued in PA
Practice address
4615 Newhall St
Philadelphia, PA 19144-4227
Phone
(267) 290-8543
NPI assigned
Jun 30, 2026
Last updated
Jun 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN269771 PA Primary

Addresses

Primary practice location

4615 Newhall St
Philadelphia, PA 19144-4227

Mailing address

4615 Newhall St
Philadelphia, PA 19144-4227

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

NPI Registry JSON

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

{
    "created_epoch": "1782777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1851218093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4615 NEWHALL ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191444227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 NEWHALL ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191444227",
            "telephone_number": "267-290-8543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLIES",
        "first_name": "BETTYANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-30",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "PN269771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; 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.