KEVIN W CARROLL (NPI# 1265470421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265470421 |
| Entity Type | Individual |
| Full Name | KEVIN W CARROLL |
| Credential | MD |
| Practice Address |
3623 Latrobe Drive Ste 216 Charlotte NC 28211 |
| Mailing Address |
Po Box 221249 Charlotte NC 28222-1249 |
| Practice Telephone | 7043321291 |
| Practice Fax Number | 7043325206 |
| Mailing Telephone | 7043321291 |
| Mailing Fax Number | 7043325206 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2020-09-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
35085 | NC | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
ME80038 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | Q35085 | 05 | |
| FL | 259310600 | 05 | |
| NC | NC LICENSE | 35085 | 01 |
| FL | FLORIDA LICENSE | ME80038 | 01 |
| AETNA HMO | 2381250 | 01 | |
| BCBS | 35604 | 01 | |
| AETNA PPO | 7444122 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033732581 | Kevin Andrew Scott Carroll II | Student in an Organized Health Care Education/Training Program | 720 Westview Dr Sw, Atlanta, GA 30310 | 2020-05-19 |
| 1861950255 | Kevin William Carroll | Student in an Organized Health Care Education/Training Program | 405 W Grand Ave, Dayton, OH 45405-7538 | 2019-03-05 |
| 1194235903 | Kevin Carroll | Counselor | 547 E 11th Ave, Columbus, OH 43211-2603 | 2017-10-06 |
| 1780131953 | Kevin Carroll | Physical Therapist | 2400 Chestnut Ave, Suite A, Glenview, IL 60026-8321 | 2016-09-06 |
| 1811337629 | Kevin H. Carroll | Internal Medicine | 2800 N Vancouver Ave Ste 230, Ohsu, Portland, OR 97227-1668 | 2013-06-26 |
| 1396960670 | Kevin Edward Carroll | Clinical Neuropsychologist | 450 Stanyan St, 400e, Rehabilitation, San Francisco, CA 94117-1079 | 2007-04-13 |
| 1881793610 | Kevin Carroll | Counselor | 1801 Hickman Rd, Des Moines, IA 50314-1505 | 2006-09-21 |
| Street Address |
3623 LATROBE DRIVE STE 216 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982613386 | Michael S Alexander | Radiology | 3623 Latrobe Drive, Ste 216, Charlotte, NC 28211 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184277832 | I and J Wheelchair Transportation | Non-emergency Medical Transport (VAN) | 1512 Delane Avenue, Charlotte, NC 28211 | 2019-07-22 |
| 1922563923 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 447 Billingsley Rd, Cottage A, Charlotte, NC 28211 | 2019-02-04 |
| 1649798273 | Ally Home Care Charlotte LLC | In Home Supportive Care | 3711 Latrobe Drive Suite 520, Charlotte, NC 28211 | 2017-09-04 |
| 1154866770 | Vaibhav Bajaj | Dentist | 2809 Coltsgate Rd Ste 200, Charlotte, NC 28211 | 2017-01-05 |
| 1508254939 | Lindsay Marie Smits | Speech-Language Pathologist | 427 N. Wendover Rd., Charlotte, NC 28211 | 2015-01-08 |
| 1457755480 | Kristen Hammer | Physical Therapy Assistant | 4120 Providence Rd Apt D, Charlotte, NC 28211 | 2014-10-20 |
| 1669805610 | Carla Elizabeth Scott | Physical Therapist | 3500 Ellington Street, Dr. Carlton Watkins Center, Charlotte, NC 28211 | 2013-08-14 |
| 1760726368 | Jill Hensdale Shipp | Social Worker | 307 Hunter Lane, Charlotte, NC 28211 | 2012-11-20 |
| 1346592722 | Danielle Marie Benoit | Occupational Therapist | 3541 Randolph Road Suite 100 W, Charlotte, NC 28211 | 2012-10-09 |
| 1487910832 | John Joseph Marcel Jr. | Orthopaedic Surgery | 449 North Wendover Rd Ste A, Charlotte, NC 28211 | 2012-04-10 |
| Find all providers in zip 28211 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003110677 | Charlotte Radiology Pa | Radiology | 1025 Morehead Medical Dr Ste 150, Charlotte, NC 28204-2973 | 2010-12-22 |
| 1144477258 | Presbyterian Imaging Centers LLC | Radiology | 13557 Steelecroft Parkway, Suite 1100, Charlotte, NC 28278 | 2008-08-20 |
| 1801097803 | Orion Imaging, LLC | Radiology | 10420 Park Rd, Ste 100, Charlotte, NC 28210-8501 | 2007-05-29 |
| 1457561912 | John D Wylie | Radiology | 3816 Latrobe Dr, Charlotte, NC 28211-1167 | 2007-05-23 |
| 1417029455 | Gregory John Duellman | Radiology | 14121 Lissadell Cir, Charlotte, NC 28277-3137 | 2006-11-14 |
| 1407926165 | Metrolina Women's Breast Center Pllc | Radiology | 439 N Wendover Road, Charlotte, NC 28211 | 2006-11-09 |
| 1932286523 | Charles Nicholas Pappas | Radiology | 609 Stockbridge Rd, Charlotte, VT 05445-9361 | 2006-11-01 |
| 1164439873 | Kenneth Fox | Radiology | 9935d Rea Rd Ste 266, Charlotte, NC 28277-6710 | 2006-08-02 |
| 1528032604 | Diane Huntington Conley | Radiology | 3815 Stoney Ridge Trl, Charlotte, NC 28210-6932 | 2006-02-15 |
| 1194796623 | Pamela Jean Culp | Radiology | Mecklenburg Radiology Associates, P.a., 3623 Latrobe Dr, Suite 216, Charlotte, NC 28211 | 2006-02-01 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.