Individual provider Active NPI

Carolyn McDonald, ACNP

  • Acute Care Nurse Practitioner
  • Newburgh, IN
National Provider Identifier
1881847549
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2008007900 Issued in IN
Practice address
10288 W State Route 66
Newburgh, IN 47630-7952
Phone
(812) 583-5864
NPI assigned
Oct 28, 2008
Last updated
Aug 31, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2008007900 IN Primary

Addresses

Primary practice location

10288 W State Route 66
Newburgh, IN 47630-7952

Mailing address

PO Box 249
Newburgh, IN 47629-0249
Phone (812) 853-5864

Other identifiers 3

IdentifierTypeStateIssuer
00000609519OtherANTHEM
200936920MedicaidIN
7100085550MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090304000550 IN Practitioner - Nurse Practitioner 4587720263 Reassigns benefits to 2 organizations
I20090427000259 KY Practitioner - Nurse Practitioner 4587720263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neff Health LLCGroup PAC ID 2062858178, 3 clinicians

Practice addresses (Care Compare)

8788 Ruffian LN
Suite B
Newburgh, IN 47630-3405
Phone (812) 492-1960

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2008007900INMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neff Health LLC Acute Care CurrentSince Jul 10, 2024 Accepting new patients
Lee Family Care PLLC PastSince Mar 1, 2020 Accepting new patients

Locations

8788 Ruffian Ln
Ste B
Newburgh, IN 47630
Phone (812) 490-7653

Interoperability endpoints

  • Direct secure messaging: carolyn.mcdonald.1@29604.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/24527/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1881847549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476290249",
            "telephone_number": "812-853-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10288 W STATE ROUTE 66",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476307952",
            "telephone_number": "812-583-5864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "CAROLYN",
        "name_prefix": "Mrs.",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "2008007900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "00000609519",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200936920",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100085550",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

Verify at the official NPI Registry.