Individual provider Active NPI

Dara Carroll

  • Family Nurse Practitioner
  • Jasper, GA
National Provider Identifier
1124603923
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN190911 Issued in GA
Practice address
175 Samaritan Dr
Jasper, GA 30143-1964
Phone
(706) 253-4633
NPI assigned
Mar 12, 2021
Last updated
May 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN190911 GA Primary

Addresses

Primary practice location

175 Samaritan Dr
Jasper, GA 30143-1964

Mailing address

175 Samaritan Dr
Jasper, GA 30143-1964
Phone (706) 253-4633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210406000914 GA Practitioner - Nurse Practitioner 2163839325 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Urgent Care LLC CurrentSince Mar 16, 2021 Accepting new patients
Rural Urgent Care LLC CurrentSince Mar 2, 2021 Accepting new patients
Rural Urgent Care LLC CurrentSince Mar 2, 2021 Accepting new patients
Good Samaritan Health & Wellness Center Inc. PastSince Jul 13, 2025 Accepting new patients
Good Samaritan Health & Wellness Center Inc. PastSince Nov 9, 2025 Accepting new patients

Locations

1500 1st Ave N
Unit 3
Birmingham, AL 35203
Phone (205) 545-5088

1408 Tallahassee Hwy
Ste Z
Bainbridge, GA 39819
Phone (229) 400-9033

25 Highland Xing S
Ellijay, GA 30540
Phone (334) 689-4025

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJECDA

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1124603923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 SAMARITAN DR",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301431964",
            "telephone_number": "706-253-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 SAMARITAN DR",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301431964",
            "telephone_number": "706-253-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "DARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-12",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN190911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, GA

Sources for this page

Verify at the official NPI Registry.