NPIMap

Individual provider Active NPI

Loren Carroll, MD

  • Family Medicine Physician
  • Jackson, TN
National Provider Identifier
1104168178
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
51998 Issued in TN
Practice address
346 Shadow Ridge Dr
Jackson, TN 38305-8507
Phone
(731) 345-0263
NPI assigned
Mar 18, 2013
Last updated
Jun 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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 51998 TN Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150421001883 TN Practitioner - Family Practice 0749409209 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
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 LLCGroup PAC ID 6800186602, 151 clinicians
Crockett Medical Clinic IncGroup PAC ID 8921009812, 7 clinicians
Ultra Health Providers II LLCGroup PAC ID 5395284616, 39 clinicians

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ultra Health Providers II LLC CurrentSince May 27, 2025 Accepting new patients
Concord Medical Group PLLC CurrentSince May 2, 2016 Accepting new patients
Crockett Medical Clinic Inc Family Medicine CurrentSince Mar 1, 2017 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince May 2, 2016 Accepting new patients
Ultra Health LLC CurrentSince Sep 3, 2018 Accepting new patients
NHC Healthcare-Milan LLC Past Accepting new patients
Black Wolf Healthcare LLC Past Accepting new patients
Crockett County Nursing Home, Inc. Past Accepting new patients
Westwood Health Care and Rehabilitation Center LLC Past Accepting new patients
Decatur County Health Care and Rehabilitation LLC Past Accepting new patients
Bear Creek Healthcare 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

  • FHIR API: https://api.platform.athenahealth.com/14578/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir-usa.unify.chbase.com/org/henders-823c208a

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
NHC Healthcare MilanMilan, TN, CCN 445069 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2020
Apr 1, 2025
Westwood Nursing and RehabilitationDecaturville, TN, CCN 445449 Skilled nursing facility Adp of the SNF Jan 1, 2025
Decatur County HealthcareParsons, TN, CCN 445451 Skilled nursing facility Managing Control - Governing Body
Adp of the SNF		 Jan 1, 2025
Jan 1, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1104168178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 SHADOW RIDGE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383058507",
            "telephone_number": "731-345-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 SHADOW RIDGE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383058507",
            "telephone_number": "731-345-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "LOREN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-18",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "51998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.