Loren Carroll, MD
Individual provider Active NPI Family Medicine Physician · Jackson, TN
NPI 1104168178 · NPPES record last updated Jun 23, 2016
Key facts
- NPI
- 1104168178
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 51998 (TN)
- Practice address
- 346 Shadow Ridge Dr
Jackson, TN 38305-8507 - Phone
- (731) 345-0263
- NPI assigned
- Mar 18, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 16
Owned or controlled facilities with NPI records 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Tennessee, HSC, College of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ultra Health LLC
Crockett Medical Clinic Inc
Ultra Health Providers II LLC
Practice addresses (Care Compare)
4128 Old Jackson Rd
Bells, TN 38006-4261
Phone (731) 394-1145
58 S Bells St
Alamo, TN 38001-1700
Phone (731) 696-5401
8017 Dogwood LN
Milan, TN 38358-6805
Phone (731) 394-1145
Hospital & facility affiliations
- Amedisys Home Health Care
- Medical Center Home Health LLC
- Tennessee Quality Care - Home Health
- Volunteer Home Care
- Gentiva
- Caris Healthcare
- Jackson-Madison County General Hospital
- Haywood County Community Hospital
- Dyersburg Regional Medical Center
- Henderson County Community Hospital
- West Tennessee Healthcare Milan Hospital
- Decatur County Healthcare
- NHC Healthcare, Milan
- Alamo Nursing and Rehabilitation Center
- Westwood Nursing and Rehabilitation
- Patriot Health and Rehabilitation Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| NHC Healthcare Milan |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jan 1, 2020 Apr 1, 2025 |
| Westwood Nursing and Rehabilitation |
Skilled nursing facility | Adp of the SNF | Jan 1, 2025 |
| Decatur County Healthcare |
Skilled nursing facility | Managing Control - Governing Body Adp of the SNF |
Jan 1, 2025 Jan 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150421001883 | TN | Practitioner - Family Practice | 0749409209 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51998 | TN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ultra Health Providers II LLC | Current |
Accepting new patients | |
| Concord Medical Group PLLC | Current |
Accepting new patients | |
| Crockett Medical Clinic Inc | Family Medicine | Current |
Accepting new patients |
| Concord Medical Group of Texas PLLC | Current |
Accepting new patients | |
| Ultra Health LLC | Current |
Accepting new patients | |
| Crockett County Nursing Home, Inc. | Past | Accepting new patients | |
| Bear Creek Healthcare LLC | Past | Accepting new patients | |
| Decatur County Health Care and Rehabilitation LLC | Past | Accepting new patients | |
| NHC Healthcare-Milan LLC | Past | Accepting new patients | |
| Black Wolf Healthcare LLC | Past | Accepting new patients | |
| Westwood Health Care and Rehabilitation Center LLC | Past | Accepting new patients |
Locations
58 S Bells St
Alamo, TN 38001
Phone (731) 696-5401
524 W Main St
Decaturville, TN 38329
Phone (731) 206-0452
5001 E Main St
Erin, TN 37061
Phone (336) 944-6420
8017 Dogwood Ln
Milan, TN 38358
Phone (731) 686-6873
608 8th Ave E
Springfield, TN 37172
Phone (615) 384-8453
Interoperability endpoints
- https://api.platform.athenahealth.com/14578/brand/1/csg/1/fhir/r4
- https://fhir-usa.unify.chbase.com/org/henders-823c208a
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 51998 | TN | Yes |
Addresses
Primary practice location
346 Shadow Ridge Dr
Jackson, TN 38305-8507
Mailing address
346 Shadow Ridge Dr
Jackson, TN 38305-8507
Phone (731) 345-0263
Other providers in Jackson, TN
- John B Carraher
- Rebecca Morris Carrington
- Samuel Mark Carrington
- Carmen Timbes Carroll
- Leslie Carroll
- Cynthia Wilson Carruth
- Larry W Carruth
- Melissa Ann Carson
- Carter Clinic LLC
- Carter Health Homecare LLC
All providers in Jackson, TN · Family Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.