Individual provider Active NPI

Jaimee Lee Carroll, FNP-C

  • Family Medicine Physician
  • Portsmouth, VA
National Provider Identifier
1235017732
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24194367 Issued in VA
Practice address
21 Constitution Ave
Portsmouth, VA 23704-1559
Phone
(757) 319-8752
NPI assigned
Aug 22, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24194367 VA Primary

Addresses

Primary practice location

21 Constitution Ave
Portsmouth, VA 23704-1559

Mailing address

21 Constitution Ave
Portsmouth, VA 23704-1559
Phone (757) 319-8752

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260127000500 VA Practitioner - Nurse Practitioner 3779060272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Procare Wellness Network IncGroup PAC ID 5294194171, 10 clinicians

Practice addresses (Care Compare)

293 Independence Blvd
Virginia Beach, VA 23462-5466
Phone (757) 222-3100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24194367VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Procare Wellness Network Inc CurrentSince Dec 9, 2025 Accepting new patients
Arc of Life Medical Center LLC PastSince Dec 9, 2025 Accepting new patients

Locations

293 Independence Blvd
Ste 330
Virginia Beach, VA 23462
Phone (757) 222-3100

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1755820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1235017732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CONSTITUTION AVE",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237041559",
            "telephone_number": "757-319-8752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CONSTITUTION AVE",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237041559",
            "telephone_number": "757-319-8752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JAIMEE",
        "middle_name": "LEE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-22",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "24194367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.