NPIMap

Individual provider Active NPI

Brian Hurd Carroll, MD

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1184684151
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2008-00321 Issued in NC
Practice address
1918 Randolph Rd
Suite 275
Charlotte, NC 28207-1100
Phone
(704) 384-1354
Fax
(704) 384-1374
NPI assigned
Mar 24, 2006
Last updated
Oct 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101047815 VA
Family Medicine Physician 207Q00000X 2008-00321 NC Primary

Addresses

Primary practice location

1918 Randolph Rd
Suite 275
Charlotte, NC 28207-1100

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-1354

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bcarroll15527@direct.novanthealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080826000825 NC Practitioner - Family Practice 9739088329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1918 Randolph Rd
Suite 275
Charlotte, NC 28207-1109
Phone (704) 384-1354

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101047815VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 1, 2009 Accepting new patients
Novant Health Medical Group, LLC Family Medicine CurrentSince Aug 1, 2009 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

1918 Randolph Rd
Ste 275
Charlotte, NC 28207
Phone (704) 342-8185

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: bcarroll15527@direct.novanthealth.org

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1184684151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-1354",
            "fax_number": "704-384-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 RANDOLPH RD",
            "address_2": "SUITE 275",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071100",
            "telephone_number": "704-384-1354",
            "fax_number": "704-384-1374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "BRIAN",
        "middle_name": "HURD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101047815",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2008-00321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bcarroll15527@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1918 Randolph Rd",
            "address_2": "Suite 275",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282071100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.