Active NPI
Mary Jana Carroll, PT
- Physical Therapist
- Mobile, AL
National Provider Identifier
1437395506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2105
- Practice address
- 2048A S Broad St
Brookley Complex
Mobile, AL 36615-1285 - Phone
- (251) 433-1414
- Fax
- (251) 433-9634
- NPI assigned
- Dec 19, 2008
- Last updated
- Feb 16, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2105 | AL | Primary |
Addresses
Primary practice location
2048A S Broad St
Brookley Complex
Mobile, AL 36615-1285
Mailing address
2048A S Broad St
Brookley Complex
Mobile, AL 36615-1285
Phone (251) 433-1414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51048200 | Other | AL | BLUE CROSS |
Other names 1
- Mrs. Jana K Carroll
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2105 | AL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Industrial Wellness Rehab, Inc | Physical Therapist | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Mobile, AL
- NPI 1437214574
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234742400000",
"number": "1437395506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2048A S BROAD ST",
"address_2": "BROOKLEY COMPLEX",
"city": "MOBILE",
"state": "AL",
"postal_code": "366151285",
"telephone_number": "251-433-1414",
"fax_number": "251-433-9634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2048A S BROAD ST",
"address_2": "BROOKLEY COMPLEX",
"city": "MOBILE",
"state": "AL",
"postal_code": "366151285",
"telephone_number": "251-433-1414",
"fax_number": "251-433-9634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "MARY",
"middle_name": "JANA",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-19",
"last_updated": "2009-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "2105",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "51048200",
"state": "AL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JANA",
"last_name": "CARROLL",
"middle_name": "K",
"prefix": "MRS.",
"credential": "PT",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.