Individual provider Active NPI

Kristen L. Carroll, M.D.

  • Pediatric Orthopaedic Surgery Physician
  • Salt Lake City, UT
National Provider Identifier
1366407488
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
184860-1205 Issued in UT
Practice address
Fairfax Road at Virginia Street
Shriners Hospital for Children
Salt Lake City, UT 84103-4399
Phone
(801) 536-3600
Fax
(801) 536-3686
NPI assigned
Apr 20, 2006
Last updated
Dec 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 184860-1205 UT
Pediatric Orthopaedic Surgery Physician 207XP3100X 184860-1205 UT Primary

Addresses

Primary practice location

Fairfax Road at Virginia Street
Shriners Hospital for Children
Salt Lake City, UT 84103-4399

Mailing address

Shriners Hospitals for Children Salt
Dept 5034
Los Angeles, CA 90084-0001
Phone (813) 281-8478

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address KCARROLL89166@DIRECT.MED.UTAH.EDU Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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

Enrollment IDStateProvider typePAC IDDetails
I20060110000661 UT Practitioner - Orthopedic Surgery 2466475074 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Albany Medical College of Union University, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hot Springs County Hospital DistrictGroup PAC ID 9234020439, shared by 6 NPIs, 21 clinicians
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

1125 Charles Ave
Worland, WY 82401-4021
Phone 3073472449612300

590 S Wakara Way
Salt Lake City, UT 84108-1200
Phone (801) 587-7109

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
184860-1205UTMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Dec 8, 2019 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Shriners Hospitals for Children Orthopaedic Surgery CurrentSince Aug 29, 2023 Accepting new patients
University of Utah Pediatric Services CurrentSince Dec 8, 2019 Accepting new patients
Shriners Hospitals for Children Pediatric Orthopaedic Surgery Current Accepting new patients
University of Utah Pediatric Services Current Accepting new patients
University of Utah Pediatric Services CurrentSince Dec 8, 2019 Accepting new patients
University of Utah Adult Services CurrentSince Dec 8, 2019 Accepting new patients
University of Utah Orthopedic Consultants Orthopaedic Surgery PastSince Sep 1, 1996 Accepting new patients
Pediatric Orthopedic Associates Past Accepting new patients

Locations

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

1275 E Fairfax Rd
Salt Lake City, UT 84103
Phone (801) 536-3500

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

100 N Mario Capecchi Dr
#4550
Slc, UT 84113
Phone (801) 662-5600

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

590 S Wakara Way
Slc, UT 84108
Phone (801) 587-7005

Interoperability endpoints

  • Direct secure messaging: kcarroll89166@direct.med.utah.edu

Organizations & group practices 10

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1366407488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SHRINERS HOSPITALS FOR CHILDREN SALT",
            "address_2": "DEPT 5034",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900840001",
            "telephone_number": "813-281-8478",
            "fax_number": "813-281-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FAIRFAX ROAD AT VIRGINIA STREET",
            "address_2": "SHRINERS HOSPITAL FOR CHILDREN",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841034399",
            "telephone_number": "801-536-3600",
            "fax_number": "801-536-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "KRISTEN",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "UT",
            "license": "184860-1205",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "UT",
            "license": "184860-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KCARROLL89166@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.