Active NPI
Nicholas McCarroll
- Psychiatry Physician
- Joplin, MO
National Provider Identifier
1114601101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 2023019861
- Practice address
- 932 E 34TH St
Joplin, MO 64804-3932 - Phone
- (417) 347-7603
- NPI assigned
- Jun 12, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 2023019861 | MO | Primary |
Addresses
Primary practice location
932 E 34TH St
Joplin, MO 64804-3932
Mailing address
PO Box 2526
Joplin, MO 64803-2526
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231228002072 | MO | Order and Referring Only - Psychiatry | 8426408782 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023019861 | MO | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686528000000",
"number": "1114601101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2526",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648032526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "932 E 34TH ST",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648043932",
"telephone_number": "417-347-7603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCARROLL",
"first_name": "NICHOLAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-06-12",
"last_updated": "2023-06-12",
"certification_date": "2023-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MO",
"license": "2023019861",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joplin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.