Thomas Carroll, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4082 Issued in TN

Practice address

5114 Old Hickory Blvd Ste 201
Hermitage, TN 37076-2590

Phone

(615) 850-6960

Fax

(615) 777-3393

NPI assigned

Sep 10, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Physician Assistant

Education

Nebraska College of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ken Homolya MD LLCGroup PAC ID 5799960464, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ken Homolya MD LLC

  • Pain Medicine Physician
  • Hendersonville, TN
  • NPI 1619266814

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Ken Homolya, MD, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Nashville, TN
  • NPI 1295209534

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1225511801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5114 OLD HICKORY BLVD STE 201",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762590",
            "telephone_number": "615-850-6960",
            "fax_number": "615-777-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5114 OLD HICKORY BLVD STE 201",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762590",
            "telephone_number": "615-850-6960",
            "fax_number": "615-777-3393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4036 Magnolia Farms Dr",
            "address_purpose": "LOCATION",
            "city": "Hermitage",
            "state": "TN",
            "postal_code": "370761645",
            "country_code": "US",
            "telephone_number": "610-730-2585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-10",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mario Abraham Cardiel Fernandez
• Cardiology Associates of Nashville
• Carespot of Hermitage (5225 Old Hickory Boulevard), LLC
• Carolyn C. Thompson, M.D. ; PC
• Noel Carpenter
• Chelsea Alexandra Carver, IBCLC
• Terry Reed Cashion, DDS
• Robin Cavataio
• Caynaan Servies LLC
• Cdxiii LLC

• Physician Assistant in Hermitage, TN
• Providers in Hermitage, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.

Verify at the official NPI Registry.