Individual provider Active NPI

Caroline Knox Lynn, CRNP

  • Nurse Practitioner
  • Montgomery, AL
National Provider Identifier
1861052144
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP1.126865 Issued in AL
Practice address
4760 Woodmere Blvd
Montgomery, AL 36106-3065
Phone
(334) 288-0814
Fax
(334) 288-3417
NPI assigned
Jun 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP1.126865 AL Primary

Addresses

Primary practice location

4760 Woodmere Blvd
Montgomery, AL 36106-3065

Mailing address

4760 Woodmere Blvd
Montgomery, AL 36106-3065
Phone (334) 288-0814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231206002757 AL Practitioner - Nephrology 3072962778 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NP1.126865ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Renal Associates of Montgomery, P.C. CurrentSince Oct 23, 2023 Accepting new patients

Locations

4760 Woodmere Blvd
Montgomery, AL 36106
Phone (334) 288-0814

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HGHAAA

Organizations & group practices 1

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": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1861052144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 WOODMERE BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063065",
            "telephone_number": "334-288-0814",
            "fax_number": "334-288-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 WOODMERE BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063065",
            "telephone_number": "334-288-0814",
            "fax_number": "334-288-3417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNN",
        "first_name": "CAROLINE",
        "middle_name": "KNOX",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "NP1.126865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.