Individual provider Active NPI

Leland Edward Carroll, D.C.

  • Chiropractor
  • Studio City, CA
National Provider Identifier
1396817359
Registry record updated Nov 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC26540 Issued in CA
Practice address
11650 Riverside Dr
Suite 8
Studio City, CA 91602-1093
Phone
(818) 760-4808
Fax
(818) 760-4809
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC26540 CA Primary

Addresses

Primary practice location

11650 Riverside Dr
Suite 8
Studio City, CA 91602-1093

Mailing address

11650 Riverside Dr
Suite 8
Studio City, CA 91602-1093
Phone (818) 760-4808

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160331000451 CA Practitioner - Chiropractic 7416254750 Reassigns benefits to 1 organization
Practice locations: Studio City, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11650 Riverside Dr
Suite 1
Studio City, CA 91602-1066
Phone (818) 647-1485

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC26540CAMDChiropractor
26540CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Carroll Chiropractic and Functional Health Solutions, Inc. Chiropractor CurrentSince Jan 1, 2020 Accepting new patients

Locations

11650 Riverside Dr
Ste 1
Studio City, CA 91602
Phone (818) 643-0517

Organizations & group practices 1

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225843200000",
    "number": "1396817359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11650 RIVERSIDE DR",
            "address_2": "SUITE 8",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916021093",
            "telephone_number": "818-760-4808",
            "fax_number": "818-760-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11650 RIVERSIDE DR",
            "address_2": "SUITE 8",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916021093",
            "telephone_number": "818-760-4808",
            "fax_number": "818-760-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "LELAND",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC26540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Studio City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.