Individual provider Active NPI

William L Carroll, MD

  • Family Medicine Physician
  • West Chester, PA
National Provider Identifier
1366422057
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD046259L Issued in PA
Practice address
1240 Wrights LN
West Chester, PA 19380-4252
Phone
(610) 431-1210
Fax
(610) 594-2625
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD046259L PA Primary

Addresses

Primary practice location

1240 Wrights LN
West Chester, PA 19380-4252

Mailing address

412 Creamery Way
Suite 400
Exton, PA 19341-2551
Phone (610) 594-7590

Other identifiers 1

IdentifierTypeStateIssuer
001608759MedicaidPW

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20060214000350 PA Practitioner - Family Practice 7810902798 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pentahealth, LLC Family Medicine CurrentSince Oct 1, 2020 Accepting new patients
Main Line Healthcare Family Medicine Past Accepting new patients

Locations

412 Creamery Way
Ste 400
Exton, PA 19341
Phone (610) 269-9448

520 Maple Ave
Ste 4
West Chester, PA 19380
Phone (610) 430-8200

1240 Wrights Ln
West Chester, PA 19380
Phone (610) 431-1210

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366422057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 CREAMERY WAY",
            "address_2": "SUITE 400",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412551",
            "telephone_number": "610-594-7590",
            "fax_number": "610-594-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 WRIGHTS LN",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193804252",
            "telephone_number": "610-431-1210",
            "fax_number": "610-594-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "WILLIAM",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD046259L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001608759",
            "state": "PW"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.