Individual provider Active NPI

Mark R Carroll, M.S., CCC-A

  • Audiologist
  • Huntsville, AL
National Provider Identifier
1366534745
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
5798 Issued in AL
Practice address
927 Franklin St SE
Suite 100
Huntsville, AL 35801-4306
Phone
(256) 536-9300
Fax
(256) 535-9032
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 5798 AL Primary

Addresses

Primary practice location

927 Franklin St SE
Suite 100
Huntsville, AL 35801-4306

Mailing address

PO Box 18066
Huntsville, AL 35804-8066
Phone (256) 536-9300

Other identifiers 3

IdentifierTypeStateIssuer
640003550OtherRAILROAD RETIREMENT
51079118OtherALBLUECROSS BLUESHIELD
009801230MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090727000528 AL Practitioner - Qualified Audiologist 1052464864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Alabama School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4245 Balmoral Dr SW
Suite 204
Huntsville, AL 35801-6497
Phone (256) 489-9992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5798ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Carroll Hearing Associates, LLC Audiologist CurrentSince Aug 1, 2012 Accepting new patients
North Alabama ENT Associates, P.C. Past Accepting new patients
North Alabama ENT Associates Past Accepting new patients

Locations

333 Whitesport Dr SW
Ste 302
Huntsville, AL 35801
Phone (256) 489-9992

4245 Balmoral Dr SW
Ste 204
Huntsville, AL 35801
Phone (256) 489-9992

Organizations & group practices 3

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1366534745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18066",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358048066",
            "telephone_number": "256-536-9300",
            "fax_number": "256-535-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 FRANKLIN ST SE",
            "address_2": "SUITE 100",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014306",
            "telephone_number": "256-536-9300",
            "fax_number": "256-535-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "M.S., CCC-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AL",
            "license": "5798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD RETIREMENT",
            "identifier": "640003550",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "51079118",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009801230",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.