Individual provider Active NPI

Victoria L. Carroll, MSN, PMHNP-BC, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1427501857
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
901673 Issued in MS
Practice address
364 S Front St Ste 201
Memphis, TN 38103-4161
Phone
(901) 296-3000
NPI assigned
Aug 2, 2016
Last updated
Feb 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 901673 MS Primary

Addresses

Primary practice location

364 S Front St Ste 201
Memphis, TN 38103-4161

Mailing address

364 S Front St Ste 201
Memphis, TN 38103-4161
Phone (901) 296-3000

Other identifiers 4

IdentifierTypeStateIssuer
1035I00515OtherTNMEDICARE TN
Q025591MedicaidTN
08934772MedicaidMS
541991YSWNOtherMSMEDICARE MS

Other names 1

  • Mrs. Tori L. Carroll Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161129001438 MS Practitioner - Nurse Practitioner 5698055119 Practice locations: Oxford, MS; Ridgeland, MS
I20161130002712 TN Practitioner - Nurse Practitioner 5698055119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Mississippi School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

364 S Front St
Suite 201
Memphis, TN 38103-4161
Phone (901) 296-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Amanda Eaves, Psychiatric Mental Health Nurse Practitioner, LLC Psychiatric/Mental Health CurrentSince Jan 1, 2020 Accepting new patients
Victoria L Carroll, Pmhnp-BC, LLC Psychiatric/Mental Health CurrentSince Oct 8, 2023 Accepting new patients
Hec Medical Psychiatric/Mental Health Past Accepting new patients

Locations

740 Avignon Dr
Ste C
Ridgeland, MS 39157
Phone (601) 937-4552

364 S Front St
Ste 201
Memphis, TN 38103
Phone (901) 296-3000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1427501857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 S FRONT ST STE 201",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381034161",
            "telephone_number": "901-296-3000",
            "fax_number": "949-543-2924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 S FRONT ST STE 201",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381034161",
            "telephone_number": "901-296-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "VICTORIA",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "MSN, PMHNP-BC, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "901673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TN",
            "identifier": "1035I00515",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q025591",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08934772",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE MS",
            "identifier": "541991YSWN",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TORI",
            "last_name": "CARROLL",
            "middle_name": "L.",
            "prefix": "MRS.",
            "credential": "MSN, PMHNP-BC, RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.