Individual provider Active NPI

Charma Mae Rolan, FNP

  • Family Nurse Practitioner
  • Mayer, AZ
National Provider Identifier
1861237414
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
309586 Issued in AZ
Practice address
20172 E Stagecoach TRL # 2357
Mayer, AZ 86333-2357
Phone
(928) 772-1673
NPI assigned
Jun 26, 2024
Last updated
Jun 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 309586 AZ Primary

Addresses

Primary practice location

20172 E Stagecoach TRL # 2357
Mayer, AZ 86333-2357

Mailing address

21 E la Pera
Green Valley, AZ 85614-2130
Phone (406) 461-8213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241101000498 AZ Practitioner - Nurse Practitioner 7719410521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carelock LLCGroup PAC ID 9436491172, 14 clinicians

Practice addresses (Care Compare)

2920 E Mohawk LN
Suite 101
Phoenix, AZ 85050-4773
Phone (480) 681-3450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
309586AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carelock, LLC Family CurrentSince Jul 15, 2024 Accepting new patients
Carelock, LLC CurrentSince Jul 15, 2024 Accepting new patients

Locations

1934 N State Route 89
Chino Valley, AZ 86323
Phone (928) 404-1488

14600 S Waterberry St
Mayer, AZ 86333
Phone (800) 725-0365

2150 W Indian School Rd
Phoenix, AZ 85015
Phone (480) 681-3450

2920 E Mohawk Ln
Ste 101
Phoenix, AZ 85050
Phone (480) 401-1555

15029 N Thompson Peak Pkwy
Ste B111
Scottsdale, AZ 85260
Phone (480) 200-9035

Interoperability endpoints

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

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1861237414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 E LA PERA",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856142130",
            "telephone_number": "406-461-8213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20172 E STAGECOACH TRL # 2357",
            "city": "MAYER",
            "state": "AZ",
            "postal_code": "863332357",
            "telephone_number": "928-772-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLAN",
        "first_name": "CHARMA",
        "middle_name": "MAE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "309586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayer, AZ

Sources for this page

Verify at the official NPI Registry.