Marvin Walter Carroll, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

K7257 Issued in TX

Practice address

3501 Knickerbocker Rd
San Angelo, TX 76904-7610

Phone

(800) 893-9698

NPI assigned

Jul 10, 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 TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Brewster Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Alpine, TX
  • NPI 1538218771
  Medicare reassignment NPD
• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019
  NPD (past)
• Oasis of West TX Emergency

  • Emergency Medicine Physician
  • San Angelo, TX
  • NPI 1457606154
  NPD (past)
• Tom Green Emergency Medicine Associates PA

  • Nurse Practitioner
  • San Angelo, TX
  • NPI 1871522508

  Emergency Medicine

  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345593600000",
    "number": "1073547451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 KNICKERBOCKER RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047610",
            "telephone_number": "800-893-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MARVIN",
        "middle_name": "WALTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2012-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "K7257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133618214",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Javier Carrillo, PHD
• Linda Leone Carrillo, MSN, APRN, PMHNP-BC
• Rosalinda Carrizales, DO
• Cynthia Sue Carroll, RPH
• Kaitlyn Carroll
• Yen Carroll, PHARMD
• Alan Keith Carson
• Carter Home Medical Equipment Inc.
• Clara Carter, APRN-FNP
• Lesley Leanne Casarez, PHD

• Emergency Medicine Physician in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2012; 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.