Charles Shannon Carroll, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

15901 Issued in MS

Practice address

291 E Layfair Dr
Flowood, MS 39232-9527

Phone

(601) 936-9190

Fax

(601) 932-6714

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

R Franklin University of Med & Sci/Chicago Medical School, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jackson Healthcare for Women PAGroup PAC ID 0345335295, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Merit Health Women'S Hospital Hospital, Flowood, MS, CCN 250136
• St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048
• Baptist Medical Center Attala Hospital, Kosciusko, MS, CCN 251336

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Jackson Healthcare for Women PA

  • Obstetrics & Gynecology Physician
  • Flowood, MS
  • NPI 1922143650
  Medicare reassignment Care Compare group NPD
• Roh LLC

  • Women's Hospital
  • Jackson, MS
  • NPI 1285681841
  NPD (past)
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• BMC - Attala, LLC

  • Critical Access Hospital
  • Kosciusko, MS
  • NPI 1730566027
  Care Compare affiliation
• Roh LLC

  • Women's Hospital
  • Jackson, MS
  • NPI 1285681841
  Care Compare affiliation
• St Dominic-Jackson Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1306876065
  Care Compare affiliation

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303257600000",
    "number": "1003846353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 E LAYFAIR DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329527",
            "telephone_number": "601-936-9190",
            "fax_number": "601-932-6714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 E LAYFAIR DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329527",
            "telephone_number": "601-936-9190",
            "fax_number": "601-932-6714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "CHARLES",
        "middle_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2011-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "15901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00120136",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Capital Orthopaedic Clinic PLLC
• Capital Orthopaedic Clinic, PLLC
• Capital Orthopedic Clinic PLLC
• Cardiovascular Institute of Mississippi, LLC
• Carmen Carr, FNP-C
• Kristin Leigh Carroll, CFNP
• Brian Carter, PHARM.D.
• Valencia Danielle Carter, PHARMD
• Peter J Casano, MD
• Rosalie A. Casano, M.D.

• Obstetrics & Gynecology Physician in Flowood, MS
• Providers in Flowood, MS by specialty
• Obstetrics & Gynecology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; 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.