Individual provider Active NPI

Carolyn Brines Ford

  • Licensed Practical Nurse
  • Calera, AL
National Provider Identifier
1902334055
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
2-063674 Issued in AL
Practice address
151 Hamilton LN
Calera, AL 35040-8700
Phone
(205) 668-4308
Fax
(205) 668-0894
NPI assigned
Jun 1, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 2-063674 AL Primary

Addresses

Primary practice location

151 Hamilton LN
Calera, AL 35040-8700

Mailing address

PO Box 689
Calera, AL 35040-0689
Phone (205) 668-4308

Other practice location 1

2100 County Services Dr
Pelham, AL 35124-6150
Phone (205) 663-1252

Other practice location 2

110 Medical Center Dr
Clanton, AL 35045-2332
Phone (205) 755-5933

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
2-063674ALMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Board of Chilton and Shelby Counties Inc Past Accepting new patients
Mental Health Board of Chilton and Shelby Counties Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/centralalabamawellness/r4/

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": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1902334055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689",
            "city": "CALERA",
            "state": "AL",
            "postal_code": "350400689",
            "telephone_number": "205-668-4308",
            "fax_number": "205-668-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 HAMILTON LN",
            "city": "CALERA",
            "state": "AL",
            "postal_code": "350408700",
            "telephone_number": "205-668-4308",
            "fax_number": "205-668-0894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 County Services Dr",
            "address_purpose": "LOCATION",
            "city": "Pelham",
            "state": "AL",
            "postal_code": "351246150",
            "country_code": "US",
            "telephone_number": "205-663-1252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Clanton",
            "state": "AL",
            "postal_code": "350452332",
            "country_code": "US",
            "telephone_number": "205-755-5933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORD",
        "first_name": "CAROLYN",
        "middle_name": "BRINES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AL",
            "license": "2-063674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calera, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.