Active NPI
John Francis Carroll, MD
- Pediatrics Physician
- Somerset, NJ
National Provider Identifier
1396869210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 123586
- Practice address
- 108 Canal Walk Blvd
Somerset, NJ 08873-7277 - Phone
- (732) 412-7324
- Fax
- (732) 412-7324
- NPI assigned
- Mar 17, 2007
- Last updated
- Jan 26, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 123586 | NY | Primary |
Addresses
Primary practice location
108 Canal Walk Blvd
Somerset, NJ 08873-7277
Mailing address
108 Canal Walk Blvd
Somerset, NJ 08873-7277
Phone (732) 412-7324
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123586 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296000000000",
"number": "1396869210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 CANAL WALK BLVD",
"city": "SOMERSET",
"state": "NJ",
"postal_code": "088737277",
"telephone_number": "732-412-7324",
"fax_number": "732-412-7324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 CANAL WALK BLVD",
"city": "SOMERSET",
"state": "NJ",
"postal_code": "088737277",
"telephone_number": "732-412-7324",
"fax_number": "732-412-7324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "JOHN",
"middle_name": "FRANCIS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-17",
"last_updated": "2011-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "123586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Somerset, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.