Active NPI
Philip John Carolin, DPM
- Foot & Ankle Surgery Podiatrist
- Bardstown, KY
National Provider Identifier
1396241733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 269144
- Practice address
- 935 Chambers Blvd Unit D
Bardstown, KY 40004-2575 - Phone
- (844) 692-3338
- Fax
- (502) 331-6309
- NPI assigned
- Apr 4, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 269144 | KY | Primary |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 07001370A | IN |
Addresses
Primary practice location
935 Chambers Blvd Unit D
Bardstown, KY 40004-2575
Mailing address
4612 Outer Loop
Louisville, KY 40219-3971
Phone (502) 804-4811
Other practice location 1
Allegheny General Hospital, 320 East North Avenue
Pittsburgh, PA 15212
Phone (412) 688-7578
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07001370A | Other | IN | MEDICAL LICENSE |
| 269144 | Other | KY | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626220800000",
"number": "1396241733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4612 OUTER LOOP",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402193971",
"telephone_number": "502-804-4811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "935 CHAMBERS BLVD UNIT D",
"city": "BARDSTOWN",
"state": "KY",
"postal_code": "400042575",
"telephone_number": "844-692-3338",
"fax_number": "502-331-6309"
}
],
"practiceLocations": [
{
"address_1": "Allegheny General Hospital, 320 East North Avenue",
"address_purpose": "LOCATION",
"city": "Pittsburgh",
"state": "PA",
"postal_code": "15212",
"country_code": "US",
"telephone_number": "412-688-7578",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CAROLIN",
"first_name": "PHILIP",
"middle_name": "JOHN",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-04",
"last_updated": "2021-07-14",
"certification_date": "2021-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "KY",
"license": "269144",
"primary": true
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "IN",
"license": "07001370A",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "07001370A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "269144",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bardstown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.