Individual provider Active NPI

Maura Katharine Carroll, MD

  • Pediatrics Physician
  • Ashburn, VA
National Provider Identifier
1174516504
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101232158 Issued in VA
Practice address
20955 Professional PLZ
Ste 200
Ashburn, VA 20147-3405
Phone
(703) 729-7652
Fax
(703) 729-8746
NPI assigned
Aug 31, 2005
Last updated
Jul 27, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101232158 VA Primary

Addresses

Primary practice location

20955 Professional PLZ
Ste 200
Ashburn, VA 20147-3405

Mailing address

PO Box 17334
Baltimore, MD 21297-1334
Phone (703) 443-6717

Other identifiers 1

IdentifierTypeStateIssuer
6737561MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131023001167 VA Practitioner - Pediatric Medicine 6305020298 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101232158VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Medical Group, PC CurrentSince Aug 1, 2013 Accepting new patients
Loudoun Medical Group, PC Pediatrics CurrentSince Aug 1, 2013 Accepting new patients
Loudoun Medical Group, PC Pediatrics PastSince Aug 1, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

20955 Professional Plz
Ste 200
Ashburn, VA 20147
Phone (703) 729-7652

224D Cornwall St NW
Ste 403
Leesburg, VA 20176
Phone (703) 737-6001

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EGIADA
  • Direct secure messaging: maura.carroll@lmg1.eclinicaldirectplus.com

Organizations & group practices 4

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1174516504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17334",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212971334",
            "telephone_number": "703-443-6717",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20955 PROFESSIONAL PLZ",
            "address_2": "STE 200",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201473405",
            "telephone_number": "703-729-7652",
            "fax_number": "703-729-8746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MAURA",
        "middle_name": "KATHARINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-31",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101232158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6737561",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

Verify at the official NPI Registry.