Individual provider Active NPI

Marissa Elizabeth Holland Carmina, LVN

  • Licensed Practical Nurse
  • Rochester, NY
National Provider Identifier
1871245647
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
313756 Issued in NY
Practice address
259 Monroe Ave
Rochester, NY 14607-3632
Phone
(315) 262-7161
NPI assigned
Jan 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 696428 CA
Licensed Practical Nurse 164W00000X 313756 NY Primary

Addresses

Primary practice location

259 Monroe Ave
Rochester, NY 14607-3632

Mailing address

256 Hinchey Rd
Rochester, NY 14624-2940
Phone (315) 262-7161

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
313756NYMDLicensed Practical Nurse
696428CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1871245647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 HINCHEY RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146242940",
            "telephone_number": "315-262-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 MONROE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146073632",
            "telephone_number": "315-262-7161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMINA",
        "first_name": "MARISSA",
        "middle_name": "ELIZABETH HOLLAND",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-24",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "696428",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "313756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.