Individual provider Active NPI

Alyssa Carroll

  • Podiatrist
  • Raleigh, NC
National Provider Identifier
1265852156
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
647 Issued in NC
Practice address
1418 E Millbrook Rd
Raleigh, NC 27609-4812
Phone
(919) 850-9111
NPI assigned
Apr 18, 2014
Last updated
Aug 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 647 NC
Foot & Ankle Surgery Podiatrist 213ES0103X 647 NC
Foot Surgery Podiatrist 213ES0131X 647 NC
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 647 NC Primary

Addresses

Primary practice location

1418 E Millbrook Rd
Raleigh, NC 27609-4812

Mailing address

1600 E Gude Dr
Ste 200
Rockville, MD 20850-1496
Phone (301) 933-7133

Other practice location 1

4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 733-1042

Other practice location 2

12610 N Community House Rd Ste 202
Charlotte, NC 28277-3838
Phone (704) 541-3668

Other practice location 3

1514 Glenwood Ave
Raleigh, NC 27608-2368
Phone (919) 829-0076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171003005507 NC Practitioner - Podiatry 0244459642 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1514 Glenwood Ave
Raleigh, NC 27608-2368
Phone (919) 829-0076

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions33
Removal of nail tissue14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
647NCMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Instride Foot and Ankle Specialists, PLLC Podiatrist CurrentSince Sep 19, 2022 Accepting new patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC Single Specialty CurrentSince Mar 1, 2018 Accepting new patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC Podiatrist CurrentSince Mar 1, 2018 Accepting new patients
Instride Foot and Ankle Specialists, PLLC Single Specialty CurrentSince Sep 19, 2022 Accepting new patients

Locations

1600 E Gude Dr
Ste 200
Rockville, MD 20850

7560 Carpenter Fire Station Rd
Ste 203
Cary, NC 27519

12610 N Community House Rd
Ste 202
Charlotte, NC 28277
Phone (704) 541-3668

1022 Lee Ann Dr NE
Concord, NC 28025
Phone (704) 786-4482

1036 Branchview Dr
Ste 216
Concord, NC 28025
Phone (704) 886-1918

130 Lake Concord Rd NE
Ste B
Concord, NC 28025
Phone (704) 786-4482

1004 Werrington Dr
Ste 300
Holly Springs, NC 27540
Phone (919) 850-9111

1418 E Millbrook Rd
Raleigh, NC 27609
Phone (919) 850-9111

1514 Glenwood Ave
Raleigh, NC 27608
Phone (919) 619-7310

3801 Wake Forest Rd
Raleigh, NC 27609
Phone (623) 522-8491

Interoperability endpoints

  • Direct secure messaging: alyssa.carroll@ifasp.eclinicaldirectplus.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1265852156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E GUDE DR",
            "address_2": "STE 200",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208501496",
            "telephone_number": "301-933-7133",
            "fax_number": "301-933-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 E MILLBROOK RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094812",
            "telephone_number": "919-850-9111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4755 Ogletown Stanton Rd",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197182200",
            "country_code": "US",
            "telephone_number": "302-733-1042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12610 N Community House Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773838",
            "country_code": "US",
            "telephone_number": "704-541-3668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1514 Glenwood Ave",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276082368",
            "country_code": "US",
            "telephone_number": "919-829-0076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "ALYSSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-18",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NC",
            "license": "647",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "647",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NC",
            "license": "647",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NC",
            "license": "647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.