Kelly Jo Carrico, N.N.P.

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

71003817A Issued in IN

Practice address

4199 Gateway Blvd
Newburgh, IN 47630-8940

Phone

(812) 842-4575

Fax

(812) 842-4549

NPI assigned

Feb 25, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1267056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1962724344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4199 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308940",
            "telephone_number": "812-842-4575",
            "fax_number": "812-842-4549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4199 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308940",
            "telephone_number": "812-842-4575",
            "fax_number": "812-842-4549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRICO",
        "first_name": "KELLY",
        "middle_name": "JO",
        "credential": "N.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-25",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MO",
            "license": "2010006352",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "IN",
            "license": "71003817A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Rivera Canlas, M.D.
• Katelyn M Cannon, NP
• Scarlett Cao, MD
• Caring Transportation Services LLC
• Jordan Carlock, DO
• Taylor Carrier
• Jeneva Carron, MA, LMHC, LPCC, CCTP
• Dartha Cartwright
• Stevee Cary, RBT
• Blair Case, SLP

• All providers in Newburgh, IN
• Neonatal Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.