Carroll L Phillips, DNP, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP013351 Issued in PA

Practice address

110 Hidden Valley Rd
MC Murray, PA 15317-2685

Phone

(724) 655-6531

NPI assigned

Oct 30, 2013

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Advanced Kidney Care Medical Associates, P.C.

  • Nephrology Physician
  • Pittsburgh, PA
  • NPI 1760468037
  Medicare reassignment NPD

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

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1003244047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 BROOKDALE CIR",
            "city": "MC MURRAY",
            "state": "PA",
            "postal_code": "153173357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HIDDEN VALLEY RD",
            "city": "MC MURRAY",
            "state": "PA",
            "postal_code": "153172685",
            "telephone_number": "724-655-6531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "372 N Craig St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152131245",
            "country_code": "US",
            "telephone_number": "412-683-7560",
            "fax_number": "412-683-6992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "CARROLL",
        "middle_name": "L",
        "credential": "DNP, CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-30",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "AG0813036",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP013351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANP",
            "identifier": "AG0813036",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Shane Petrie, M.D.
• Michael Anthony Pezzone, DC
• Shayna Pezzone, DC
• Beth Phillips
• Brianna Marie Phillips, OTR/L
• Physician Landing Zone, P.C.
• Physician Landing Zone, P.C.
• Physician Landing Zone, P.C.
• Physician Landing Zone, P.C.
• Susan Pilossoph, M.D.

• Nurse Practitioner in MC Murray, PA
• Providers in MC Murray, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.