NPIMap

Individual provider Active NPI

Brian A McCarroll, D.O.

  • Family Medicine Physician
  • Bruce TWP, MI
National Provider Identifier
1093779670
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
BM007710 Issued in MI
Practice address
80600 Van Dyke Rd
Bruce TWP, MI 48065-1333
Phone
(810) 798-6560
Fax
(810) 798-6563
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X BM007710 MI Primary

Addresses

Primary practice location

80600 Van Dyke Rd
Bruce TWP, MI 48065-1333

Mailing address

80600 Van Dyke Rd
Bruce TWP, MI 48065-1333
Phone (810) 798-6560

Other identifiers 6

IdentifierTypeStateIssuer
104279OtherMICARE CHOICES
4679001MedicaidMI
000549480OtherMIUNITED HEALTH CARE
2351230003OtherMICIGNA HEALTH CARE
0154410164OtherMIBCBS OF MI
C8031OtherMIM-CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
BM007710MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McCarroll Primary Care Family Medicine Past Accepting new patients
Henry Ford Macomb Hospital Corporation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bmccarroll240949@direct.hfhs.org

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1093779670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80600 VAN DYKE RD",
            "city": "BRUCE TWP",
            "state": "MI",
            "postal_code": "480651333",
            "telephone_number": "810-798-6560",
            "fax_number": "810-798-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80600 VAN DYKE RD",
            "city": "BRUCE TWP",
            "state": "MI",
            "postal_code": "480651333",
            "telephone_number": "810-798-6560",
            "fax_number": "810-798-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARROLL",
        "first_name": "BRIAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "BM007710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "104279",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4679001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "000549480",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH CARE",
            "identifier": "2351230003",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "0154410164",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M-CARE",
            "identifier": "C8031",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bruce TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; 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.