Laura Carravallah, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301054994 Issued in MI

Practice address

5710 Clio Rd
Flint, MI 48504-1524

Phone

(810) 787-4445

Fax

(810) 244-8901

NPI assigned

Jan 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Hurley Medical Center

  • Obstetrics & Gynecology Physician
  • Flint, MI
  • NPI 1982630844

  MI

  Medicare reassignment NPD
• Hurley Medical Center

  • Family Medicine Physician
  • Flint, MI
  • NPI 1477088904

  Internal Medicine

  NPD
• Pathology Associates Inc PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Flint, MI
  • NPI 1922116094
  NPD

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321315200000",
    "number": "1255311908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E 5TH ST",
            "address_2": "SUITE 300",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485021641",
            "telephone_number": "810-406-4246",
            "fax_number": "810-424-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5710 CLIO RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485041524",
            "telephone_number": "810-787-4445",
            "fax_number": "810-244-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRAVALLAH",
        "first_name": "LAURA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2011-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301054994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1386624278",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4350553",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Carr
• Jimmie Carr
• Caryl Renee Carradine, RDH
• Dimetria Carradine
• Lashanda Lanise Carradine
• Shamaria Carrington
• Andrea Carroll
• Daniel Patrick Carroll, D.M.D.
• Milton Carroll
• Susan Elizabeth Carsten, LMSW

• All providers in Flint, MI
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.