Wanda Carroll, PTA, LMT, CNA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A3443 Issued in MD

Practice address

839 Cottonwood Dr
Severna Park, MD 21146-2836

Phone

(443) 986-2959

NPI assigned

Apr 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1356566731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 COTTONWOOD DR",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462836",
            "telephone_number": "443-986-2959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 COTTONWOOD DR",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462836",
            "telephone_number": "443-986-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "WANDA",
        "credential": "PTA, LMT, CNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "M00487",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MD",
            "license": "M00487",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A3443",
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "MD",
            "license": "A00010416",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MD",
            "license": "A00010416",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karly Campbell, MSOTRL
• Amanda McPherson Canizales, D.D.S.
• Kathryn Demarinis Capozzoli, APRN, BC, PMH
• Michael D Cardaci, LCPC
• Diane T Carey, MA SLP
• Jessica Noemy Castro-Pocasangre
• Kristina G. Castro, DPT
• Centennial Medical Group, PA
• Heather Lynn Chadwick, LCSW-C
• Chazbro Inc

• Physical Therapy Assistant in Severna Park, MD
• Providers in Severna Park, MD by specialty
• Physical Therapy Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.