DR. JOHN T CARROLL (NPI# 1578507588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578507588 |
| Entity Type | Individual |
| Full Name | DR. JOHN T CARROLL |
| Credential | M.D. |
| Practice Address |
1673 Mason Ave Suite # 305 Daytona Beach FL 32117-5515 |
| Practice Telephone | 3862747118 |
| Practice Fax Number | 3862746173 |
| Mailing Telephone | 3862747118 |
| Mailing Fax Number | 3862746173 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2010-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
ME0077295 | FL | Allopathic & Osteopathic Physicians |
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
ME0077295 | FL | Allopathic & Osteopathic Physicians |
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
ME0077295 | FL | Allopathic & Osteopathic Physicians |
| N | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
ME0077295 | FL | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
ME0077295 | FL | Allopathic & Osteopathic Physicians |
| N | 2085R0203X |
Radiology Specialization: Therapeutic Radiology |
ME0077295 | FL | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
ME0077295 | FL | Allopathic & Osteopathic Physicians |
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
ME0077295 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 256064000 | 05 | |
| FL | BLUE CROSS BLUE SHIELD | 46215 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043853658 | John Carroll | Marriage & Family Therapist | 400 W 23rd St Apt 5j, New York, NY 10011-2176 | 2019-10-26 |
| 1376852301 | John Carroll | Emergency Medicine | 2727 W Heading Ave, West Peoria, IL 61604-4981 | 2010-09-24 |
| 1417151440 | John Raymond Carroll | Student in an Organized Health Care Education/Training Program | 42 E. Laurel Rd, Udp At Umdnj-som, Dept. of Family Medicine, Rm 2100, Stratford, NJ 08084 | 2007-06-13 |
| 1396869210 | John Francis Carroll | Pediatrics | 108 Canal Walk Blvd, Somerset, NJ 08873-7277 | 2007-03-17 |
| 1508946054 | John T Carroll | Podiatrist | 455 Boston Post Rd Ste 8, Old Saybrook, CT 06475-1554 | 2006-10-17 |
| 1457379042 | John Thomas Carroll | Obstetrics & Gynecology | 503 Thornhill Dr, Carol Stream, IL 60188-2780 | 2006-07-18 |
| 1952340069 | John L Carroll | Dentist | 1020 5th St Se, Winter Haven, FL 33880-4210 | 2006-06-05 |
| 1063468932 | John Anthony Carroll | Internal Medicine | 8328 E Hartford Dr, Scottsdale, AZ 85255-6520 | 2006-05-25 |
| 1508811860 | John D Carroll | Internal Medicine | 10689 Hardin Valley Rd, Knoxville, TN 37932-1504 | 2006-05-24 |
| 1376511717 | John M Carroll | Internal Medicine | 390 Pleasant St, Malden, MA 02148-8114 | 2006-03-10 |
| Street Address |
1673 MASON AVE SUITE # 305 |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32117-5515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942207709 | Thomas J Green Jr. | Radiology | 1673 Mason Ave, Suite 305, Daytona Beach, FL 32117-5515 | 2005-07-07 |
| 1255978896 | Angela Cook | Social Worker | 1673 Mason Ave, Daytona Beach, FL 32117-5515 | 2019-12-03 |
| 1750940722 | Andrea Gollegly | Social Worker | 1673 Mason Ave, Daytona Beach, FL 32117-5515 | 2019-06-12 |
| 1235620527 | Precious Monique Spencer | Registered Nurse | 1673 Mason Ave, Daytona Beach, FL 32117-5515 | 2018-05-23 |
| 1124537592 | Beverly Jean Craigle | Registered Nurse | 1673 Mason Ave, Daytona Beach, FL 32117-5515 | 2017-09-28 |
| 1659829216 | Mackenzie Schwarb | Social Worker | 1673 Mason Ave, Suite 100, Daytona Beach, FL 32117-5515 | 2016-09-13 |
| 1841621117 | Preferred Radiology Alliance, Pllc | Radiology | 1673 Mason Ave, Suite 305, Daytona Beach, FL 32117-5515 | 2013-12-11 |
| 1285834002 | Marjorie A Thurlow | Radiology | 1673 Mason Ave, Suite# 305, Daytona Beach, FL 32117-5515 | 2007-07-19 |
| 1619037025 | Craig A. Roberto | Radiology | 1673 Mason Ave, Suite# 305, Daytona Beach, FL 32117-5515 | 2006-12-08 |
| 1003905290 | John William Gianini | Radiology | 1673 Mason Ave, Suite 305, Daytona Beach, FL 32117-5515 | 2006-10-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992350409 | Erin Selfridge | Pharmacist | 1500 Beville Rd #300, Daytona Beach, FL 32117 | 2019-08-02 |
| 1881185494 | Wellspring Health, LLC | Chiropractor | 701 Ridgewood Ave, Holly Hills, FL 32117 | 2018-05-21 |
| 1780172791 | L & L Db, LLC | Clinic/Center | 1540 Cornerstone Blvd, Suite 100, Daytona Beach, FL 32117 | 2018-04-25 |
| 1154837789 | Brittany Nikolow | Nurse Practitioner | 1717 N. Clyde Morris, Daytona Beach, FL 32117 | 2017-12-19 |
| 1205356946 | Alejandro Andre Pabon Rodriguez | Nurse Anesthetist, Certified Registered | Florida Hospital Memorial Medical Center, 301 Memorial Medical Parkway, Daytona Beach, FL 32117 | 2017-06-23 |
| 1316492135 | Ann Van Herck | Physical Therapist | 1901 Mason Ave Ste 105, Daytona Beach, FL 32117 | 2016-08-22 |
| 1952784779 | Kathryn Brenna Copley | Nurse Practitioner | 1890 Lpga Blvd., Daytona Beach, FL 32117 | 2015-06-30 |
| 1053719559 | Alicia Graham | Case Manager/Care Coordinator | 1570 Megan Bay Circle, Holly Hill, FL 32117 | 2014-12-15 |
| 1578974440 | Halifax Senior Care Inc | Clinic/Center | 1515 Ridgewood Ave, Suite B, Holly Hill, FL 32117 | 2014-05-14 |
| 1013345883 | Kist Alf, Inc | Assisted Living Facility | 1516 Carmen Avenue, Daytona Beach, FL 32117 | 2013-10-14 |
| Find all providers in zip 32117 | ||||
| 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 |
|---|---|---|---|---|
| 1720391568 | Ameneh Mashayekh | Radiology | 1673 Mason Ave Ste 305, Daytona Beach, FL 32117-5516 | 2010-07-21 |
| 1558484956 | Charles Robert Dearmas Jr. | Radiology | 350 N. Clyde Morris Blvd., Suite D, Daytona Beach, FL 32114-2733 | 2007-04-09 |
| 1558463950 | Krishnan - Gopal | Radiology | 551 National Health Care Drive, Daytona Beach, FL 32114 | 2006-09-05 |
| 1922115914 | Memorial Health Systems Inc | Radiology | 305 Memorial Medical Pkwy Ste 205, Daytona Beach, FL 32117-5169 | 2006-08-24 |
| 1396701165 | Neville Ramchander | Radiology | 3000 N Atlantic Ave, Unit #4, Daytona Beach, FL 32118-3019 | 2006-04-21 |
| 1609832419 | Ormond Radiology Partnership LLC | Radiology | 201 Bill France Blvd, Daytona Beach, FL 32114-1316 | 2006-04-21 |
| 1437120854 | Howard Huff Fawley Jr. | Radiology | 350 North Clyde Morris Blvd, Daytona Beach, FL 32114-2733 | 2006-02-01 |
| 1336566330 | Jessica Riotti | Radiology | 1673 Mason Ave Ste 305, Daytona Beach, FL 32117-5516 | 2014-03-27 |
| 1841621117 | Preferred Radiology Alliance, Pllc | Radiology | 1673 Mason Ave, Suite 305, Daytona Beach, FL 32117-5515 | 2013-12-11 |
| 1710230982 | Joshua Phillip Zeidenberg | Radiology | 1673 Mason Ave Ste 305, Daytona Beach, FL 32117-5516 | 2012-10-24 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32117 |
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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.