Anthony J Decarlo Jr.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

48239 Issued in WV

Practice address

4510 Pennsylvania Ave Ste C
Charleston, WV 25302-4835

Phone

(304) 965-9081

Fax

(304) 346-1860

NPI assigned

Dec 9, 2020

Last updated

Dec 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1952907453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 BURGESS DR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253128143",
            "telephone_number": "304-932-6743",
            "fax_number": "304-471-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 PENNSYLVANIA AVE STE C",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253024835",
            "telephone_number": "304-965-9081",
            "fax_number": "304-346-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECARLO",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-09",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "48239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "tonydecarlorn@gmail.com",
            "affiliation": "N",
            "endpointDescription": "EMAIL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4510 Pennsylvania Ave Ste C",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253024835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Registered Nurse in Charleston, WV
• Providers in Charleston, WV by specialty
• Registered Nurse in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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.