Kelly Carroll McQueen, AUD, CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

2201001692 Issued in VA

Practice address

1320 Old Chain Bridge Rd Ste 185
MC Lean, VA 22101

Phone

(703) 942-8110

NPI assigned

Feb 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Kelly Nicole Carroll Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Hearx West Inc

  • Audiologist-Hearing Aid Fitter
  • Bakersfield, CA
  • NPI 1336304922
  NPD (past)
• Hearx West, LLC

  • Audiologist-Hearing Aid Fitter
  • Bakersfield, CA
  • NPI 1356398598
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1417098971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 OLD CHAIN BRIDGE RD STE 185",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013945",
            "telephone_number": "703-866-8819",
            "fax_number": "855-750-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 OLD CHAIN BRIDGE RD STE 185",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "22101",
            "telephone_number": "703-942-8110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 Old Chain Bridge Rd Ste 180",
            "address_purpose": "LOCATION",
            "city": "Mc Lean",
            "state": "VA",
            "postal_code": "221013919",
            "country_code": "US",
            "telephone_number": "703-942-8110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCQUEEN",
        "first_name": "KELLY",
        "middle_name": "CARROLL",
        "credential": "AUD, CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU 2286",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "VA",
            "license": "2101002412",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201001692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "CARROLL",
            "middle_name": "NICOLE",
            "prefix": "DR.",
            "credential": "MS, CCC-A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• McLean Tysons Orthopedic Surgery Center, LLC
• Darius McLean, PA-C
• Michele McLellan, PT
• Doreen Ella McMahon, MD
• Katherine McMorrow
• Rahel Mebrahtu, MSN-FNP, BC
• Medex Pharmacy LLC
• Medstar Endoscopy Center Virginia, LLC
• Medstar Health Physical Therapy at Home, LLC.
• Medstar Medical Group II LLC

• Audiologist in MC Lean, VA
• Providers in MC Lean, VA by specialty
• Audiologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.