Active NPI
Ronald Kevin Carroll, DO
- Emergency Medicine Physician
- Garden City, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 0102202951
- Practice address
- 6245 Inkster Rd
Garden City, MI 48135-4001 - Phone
- (734) 458-4486
- Fax
- (734) 458-4496
- NPI assigned
- Aug 10, 2007
- Last updated
- Feb 17, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 2116 | TN | |
| Emergency Medicine Physician | 207P00000X | 5101017465 | MI | |
| Emergency Medicine Physician | 207P00000X | 0102202951 | VA | Primary |
| General Practice Physician | 208D00000X | 5101017465 | MI |
Addresses
Primary practice location
6245 Inkster Rd
Garden City, MI 48135-4001
Mailing address
197 Laurel LN
Canton, MI 48187-4591
Phone (865) 776-5333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 844-1121
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102202951 | VA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-Cities Regional Emergency Physicians, PC | Emergency Medicine | Current | Accepting new patients |
| Wellmont Medical Associates, Inc. | Current | Accepting new patients | |
| Wellmont Medical Associates Inc | Current | Accepting new patients | |
| Omni Health Services, LTD | Emergency Medicine | Past | Accepting new patients |
Locations
1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451
1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000
401 Takoma Ave
Greeneville, TN 37743
Phone (423) 639-3151
400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310
105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220
111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197
130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150
1519 Main St
Sneedville, TN 37869
Phone (423) 733-5000
1990 Holton Ave E
Big Stone Gap, VA 24219
Phone (276) 523-3111
100 15th St NW
Norton, VA 24273
Phone (276) 439-1000
Organizations & group practices 6
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.
-
- Emergency Medicine Physician
- Johnson City, TN
- NPI 1063950046
-
dba Ballad Health Medical Associates
- Pulmonary Disease Physician
- Bristol, TN
- NPI 1780986257
-
- Emergency Medicine Physician
- Norton, VA
- NPI 1386183028
-
dba Ballad Health Medical Associates
- Psychiatry Physician
- Johnson City, TN
- NPI 1275393522
-
- Emergency Medicine Physician
- Defiance, OH
- NPI 1932380086
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Indian Path Community Hospital
- General Acute Care Hospital
- Kingsport, TN
- NPI 1992813240
-
dba Bristol Regional Medical Center
- General Acute Care Hospital
- Bristol, TN
- NPI 1124058615
-
dba Holston Valley Medical Center
- General Acute Care Hospital
- Kingsport, TN
- NPI 1487690400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645056000000",
"number": "1215129515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "197 LAUREL LN",
"city": "CANTON",
"state": "MI",
"postal_code": "481874591",
"telephone_number": "865-776-5333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6245 INKSTER RD",
"city": "GARDEN CITY",
"state": "MI",
"postal_code": "481354001",
"telephone_number": "734-458-4486",
"fax_number": "734-458-4496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "RONALD",
"middle_name": "KEVIN",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-10",
"last_updated": "2022-02-17",
"certification_date": "2022-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TN",
"license": "2116",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MI",
"license": "5101017465",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "VA",
"license": "0102202951",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MI",
"license": "5101017465",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Garden City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.