Individual provider Active NPI

Christopher Allen Carroll, PT, DPT

  • Physical Therapist
  • Harrison, AR
National Provider Identifier
1053971838
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT4702 Issued in AR
Practice address
1409 Highway 62 65 N Ste 4
Harrison, AR 72601-1970
Phone
(870) 704-4076
Fax
(870) 741-0089
NPI assigned
Jun 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CP007656T MO
Physical Therapist 225100000X PT4702 AR Primary

Addresses

Primary practice location

1409 Highway 62 65 N Ste 4
Harrison, AR 72601-1970

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190927000942 AR Practitioner - Physical Therapist in Private Practice 2961732342 Reassigns benefits to 1 organization
I20210910002150 MO Practitioner - Physical Therapist in Private Practice 2961732342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Serc Rebabilitation Partners, LLCGroup PAC ID 9830344563, 212 clinicians

Practice addresses (Care Compare)

115 Audubon Dr
Suite 9
Maumelle, AR 72113-7409
Phone (501) 255-3699

1227 E 32ND St
7 Serc Joplin
Joplin, MO 64804-2904
Phone (417) 624-7400

2603 W Pleasant Grove Rd
104 Serc Rogers
Rogers, AR 72758-8514
Phone (816) 226-4011

605 Salem Rd
Suite A5
Conway, AR 72034-4862
Phone (501) 441-5843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT4702ARMDPhysical Therapist
CP007656TMOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Serc Rebabilitation Partners, LLC Physical Therapist CurrentSince Aug 20, 2019 Accepting new patients
Serc Rehabilitation Partners, LLC Physical Therapist CurrentSince Aug 20, 2019 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

605 Salem Rd
Ste A5
Conway, AR 72034
Phone (501) 441-4862

1409 Highway 62 65 N
Ste 4
Harrison, AR 72601
Phone (870) 704-1970

115 Audubon Dr
Ste 9
Maumelle, AR 72113
Phone (501) 255-3699

2603 W Pleasant Grove Rd
Ste 104
Rogers, AR 72758
Phone (479) 636-1187

1225 SW State Route 7
Blue Springs, MO 64014
Phone (816) 295-2051

109 W Franklin St
Clinton, MO 64735
Phone (660) 383-1280

180 Mall Rd
Ste K
Hollister, MO 65672
Phone (417) 263-3045

1227 E 32nd St
Ste 7
Joplin, MO 64804
Phone (417) 624-7400

334 E Mount Vernon Blvd
Mount Vernon, MO 65712
Phone (417) 423-7410

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1053971838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 HIGHWAY 62 65 N STE 4",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726011970",
            "telephone_number": "870-704-4076",
            "fax_number": "870-741-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "CHRISTOPHER",
        "middle_name": "ALLEN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-14",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "CP007656T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT4702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.