Carolyn Carroll Mitchell Waiboer, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

20580 Issued in SC

Practice address

1028 N Church St
Greenville, SC 29601-1639

Phone

(864) 271-1464

NPI assigned

Dec 21, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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 1

Specialty

Nurse Practitioner

Education

Medical University of South Carolina College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Carolina Dept of Mental Health Accounting OfficeGroup PAC ID 9032021175, 226 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South Carolina Dept of Mental Health Accounting Office

  • Primary Care Nurse Practitioner
  • Bennettsville, SC
  • NPI 1295332690
  Medicare reassignment Care Compare group NPD
• South Carolina Dept of Mental Health Accounting Office

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1083421994
  NPD
• South Carolina Dept of Mental Health Accounting Office

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Anderson, SC
  • NPI 1508814625
  NPD
• St Francis Physician Services Inc

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295769438
  NPD (past)

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1992240394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 HALF MILE PL",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296091500",
            "telephone_number": "864-901-6788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 N CHURCH ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296011639",
            "telephone_number": "864-271-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAIBOER",
        "first_name": "CAROLYN CARROLL",
        "middle_name": "MITCHELL",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kurt Allen Wagner, LAT, ATC
• Lisa Wagner, LPN
• Madison Wagner
• Michael J Wagner, PHARMD
• Michael Sean Wagner, M.D.
• Waive Diagnostics, LLC
• Wal-Mart Stores East , LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP

• Family Nurse Practitioner in Greenville, SC
• Providers in Greenville, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.