Individual provider Active NPI

David K Carroll, P.T.

  • Physical Therapist
  • Pella, IA
National Provider Identifier
1154575785
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
03101 Issued in IA
Practice address
405 Monroe St
Pella, IA 50219-1189
Phone
(641) 628-6623
Fax
(641) 621-2223
NPI assigned
Nov 10, 2008
Last updated
Feb 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 03101 IA Primary
Physical Therapist 225100000X 2005037318 MO

Addresses

Primary practice location

405 Monroe St
Pella, IA 50219-1189

Mailing address

405 Monroe St
Pella, IA 50219-1189
Phone (641) 628-6623

Other identifiers 1

IdentifierTypeStateIssuer
03101OtherIAIOWA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040818000877 IA Practitioner - Physical Therapist in Private Practice 1052384963 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pella Regional Health CenterGroup PAC ID 9931005873, shared by 10 NPIs, 96 clinicians

Practice addresses (Care Compare)

405 Monroe St
Pella, IA 50219-1189
Phone (641) 628-3832

Merit-based Incentive Payment System (MIPS)

Final score
91.84 of 100Reported as group
Quality
91.13
Promoting interoperability
100
Improvement activities
40
Cost
81.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2005037318MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pella Regional Health Center CurrentSince Feb 1, 2016 Accepting new patients
Pella Regional Health Center CurrentSince Feb 1, 2016 Accepting new patients
Pella Regional Health Center Current Accepting new patients

Locations

2525 Washington St
Pella, IA 50219
Phone (641) 621-1401

405 Monroe St
Pella, IA 50219
Phone (641) 621-2200

Organizations & group practices 3

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": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455753600000",
    "number": "1154575785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 MONROE ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191189",
            "telephone_number": "641-628-6623",
            "fax_number": "641-621-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 MONROE ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191189",
            "telephone_number": "641-628-6623",
            "fax_number": "641-621-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "DAVID",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-10",
        "last_updated": "2016-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03101",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2005037318",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA LICENSE",
            "identifier": "03101",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pella, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.