KIM MARION CAROLLO NP NPI 1972072114

NPI Information

NPI: 1972072114
Provider Name: KIM MARION CAROLLO, NP
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
1000 BLYTHE BLVD
CMC ANNEX, 1ST FLOOR
CHARLOTTE, NC
ZIP 28203
Phone: (704) 355-0270
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Kim Marion Carollo, NP is an acute care nurse practitioner in Charlotte, NC with 6 years of experience. Kim Marion Carollo, NP NPI is 1972072114. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1000 BLYTHE BLVD
CMC ANNEX, 1ST FLOOR
CHARLOTTE, NC
ZIP 28203
Phone: (704) 355-0270

The NPI 1972072114 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/16/2018 and was last updated on 1/31/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	23520	SOUTH CAROLINA	No
2	363LA2100X	Nurse Practitioner	Acute Care	RN282977	GEORGIA	No
3	363LA2100X	Nurse Practitioner	Acute Care	5012470	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	NP64661	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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