Janet Carroll, R.N., M.T.

Primary specialty

Nurse Massage Therapist (NMT)Taxonomy code 163WM1400X

License

28057959A Issued in IN

Practice address

5111 N Bend Dr
Fort Wayne, IN 46804-1753

Phone

(260) 436-8807

Fax

(260) 436-2767

NPI assigned

Aug 19, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician, Registered Nurse

State licenses

Practice roles

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.

• Vital Living Therapeutic Massage, LLC

  • Nurse Massage Therapist (NMT)
  • Fort Wayne, IN
  • NPI 1790151157
  NPD (past) Authorized official

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1124494505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 N BEND DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041753",
            "telephone_number": "260-436-8807",
            "fax_number": "260-436-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 N BEND DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041753",
            "telephone_number": "260-436-8807",
            "fax_number": "260-436-2767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JANET",
        "credential": "R.N., M.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM1400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nurse Massage Therapist (NMT)",
            "state": "IN",
            "license": "28057959A",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IN",
            "license": "MT20901877",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE THERAPIST",
            "identifier": "MT20901877",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "28057959A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Carrico, PA
• Julie A Carrico, SLP
• Kiersten Rene Carrico, PA-C
• Bella Carrillo
• Betsy Carroll
• Carter Hearing Clinics LLC
• Ashlee Denise Carter, CNM
• Edmund P Carter, MA
• Hafeezah Carter
• Kylah Carter, RBT

• Nurse Massage Therapist (NMT) in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Nurse Massage Therapist (NMT) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.