Mark Blanchard Carroll, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

78859 Issued in NC

Practice address

Medical Center Blvd
Winston Salem, NC 27157-0001

Phone

(336) 716-2255

NPI assigned

Jul 18, 2006

Last updated

Jan 24, 2012By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Epilepsy Institute of NC

  • Neurology Physician
  • Winston Salem, NC
  • NPI 1710929088
  NPD (past)
• New River Service Authority

  dba New River Behavioral HealthCare

  • Community/Behavioral Health Agency
  • Lenoir, NC
  • NPI 1659532562
  NPD (past)
• New River Service Authority

  dba New River Behavioral Healthcare

  • Foster Care Agency
  • Boone, NC
  • NPI 1720360944
  NPD (past)
• The Epilepsy Institute of NC

  • Psychologist
  • Winston Salem, NC
  • NPI 1477939213
  NPD (past)
• Triumph LLC

  • Clinical Social Worker
  • Raleigh, NC
  • NPI 1003961269
  NPD (past)
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1073531679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 344",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271020344",
            "telephone_number": "336-716-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MARK",
        "middle_name": "BLANCHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": "78859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eben A Carroll, MD
• Elizabeth Carroll, PH.D.
• Kendall Carroll, AUD
• Kristal Doub Carroll, WHNP
• Madeleine Margaret Carroll, MD
• Aileen Patrice Carson
• Jenna Leigh Carter Hamed, MD
• Leslie Gabrielle Carter-Nuega
• Alicia Jane Carter, FNP
• Alisha Carter

• Child & Adolescent Psychiatry Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Child & Adolescent Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.