Individual provider Active NPI

Alice Leeann Carroll, FNP

  • Family Nurse Practitioner
  • Vincennes, IN
National Provider Identifier
1235769381
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F11190576 Issued in IN
Practice address
1813 Willow St Ste 3
Vincennes, IN 47591-4276
Phone
(812) 885-8941
Fax
(812) 885-8940
NPI assigned
Jan 16, 2020
Last updated
Feb 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F11190576 IN Primary

Addresses

Primary practice location

1813 Willow St Ste 3
Vincennes, IN 47591-4276

Mailing address

520 S 7TH St
Vincennes, IN 47591-1038
Phone (812) 885-3453

Other practice location 1

520 S 7th St
Vincennes, IN 47591-1038
Phone (812) 885-3453

Other practice location 2

1216 Washington Ave
Vincennes, IN 47591-2245
Phone (812) 885-6960

Other practice location 3

1314 E Walnut St
Washington, IN 47501-2860
Phone (812) 698-8206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20210820000779 IN Practitioner - Nurse Practitioner 6406251057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

520 S 7TH St
Vincennes, IN 47591-1038
Phone (812) 885-3280

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F11190576INMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Physician Services, Inc CurrentSince May 21, 2021 Accepting new patients
Good Samaritan Hospital CurrentSince May 21, 2021 Accepting new patients
Good Samaritan Hospital Physician Services Inc. PastSince Jun 15, 2021 Accepting new patients

Locations

1160 E Saint Clair St
Vincennes, IN 47591
Phone (812) 882-1064

1216 Washington Ave
Vincennes, IN 47591
Phone (812) 885-6960

1813 Willow St
Ste 3
Vincennes, IN 47591
Phone (812) 885-8941

520 S 7th St
Vincennes, IN 47591
Phone (812) 885-3280

1314 E Walnut St
Washington, IN 47501
Phone (812) 254-2250

Organizations & group practices 3

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 2

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": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1235769381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S 7TH ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911038",
            "telephone_number": "812-885-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 WILLOW ST STE 3",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475914276",
            "telephone_number": "812-885-8941",
            "fax_number": "812-885-8940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 S 7th St",
            "address_purpose": "LOCATION",
            "city": "Vincennes",
            "state": "IN",
            "postal_code": "475911038",
            "country_code": "US",
            "telephone_number": "812-885-3453",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1216 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Vincennes",
            "state": "IN",
            "postal_code": "475912245",
            "country_code": "US",
            "telephone_number": "812-885-6960",
            "fax_number": "812-885-6961",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1314 E Walnut St",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "IN",
            "postal_code": "475012860",
            "country_code": "US",
            "telephone_number": "812-698-8206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "ALICE",
        "middle_name": "LEEANN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-16",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "F11190576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

Verify at the official NPI Registry.