Rebekah Joy Carroll, CNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0034198 Issued in OH

Practice address

775 Lexington Ave
Mansfield, OH 44907-1906

Phone

(419) 774-4010

NPI assigned

Mar 16, 2018

Last updated

Jun 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Village Network

  dba The Village Network

  • Voluntary or Charitable Agency
  • Wooster, OH
  • NPI 1124057914
  Medicare reassignment NPD
• Village Network

  dba The Village Network

  • Voluntary or Charitable Agency
  • Wooster, OH
  • NPI 1093103988
  NPD

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

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1467955310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1363 WIGTON RD",
            "city": "LUCAS",
            "state": "OH",
            "postal_code": "448439328",
            "telephone_number": "419-603-6691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071906",
            "telephone_number": "419-774-4010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8402 Blackjack Rd",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "OH",
            "postal_code": "430509193",
            "country_code": "US",
            "telephone_number": "740-788-0220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "REBEKAH",
        "middle_name": "JOY",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-16",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0034198",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OH",
            "license": "416102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James L. Carpenter
• Taylor G. Carpenter
• Wyatt Carpenter
• Bunny L Carroll
• Lisa Carroll
• Tonya Michelle Carroll
• Clayton Scott Carsner
• Linda Carson, LPCC E
• Ann Denise Carter, RN
• Maria Carter

• Psychiatric/Mental Health Nurse Practitioner in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.