Kathleen Leah Carroll, APN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP115115 Issued in TX

Practice address

113 Pleasant Valley Dr Ste 210
Boerne, TX 78006-5683

Phone

(830) 267-4575

NPI assigned

Jul 26, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Geriatric Associates of America-Texas, PLLC

  • Internal Medicine Physician
  • Webster, TX
  • NPI 1669682886

  Gerontology

  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1477577567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 PLEASANT VALLEY DR",
            "address_2": "STE 210",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780065683",
            "telephone_number": "830-267-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 PLEASANT VALLEY DR STE 210",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780065683",
            "telephone_number": "830-267-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "KATHLEEN",
        "middle_name": "LEAH",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "516229",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP115115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182691901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raymond Lee Carger
• Daniel W Carney, LPC
• Caroline B Williams PHD PC
• Carpenter Health Management, LLC
• Chad A Carpenter, D.C.
• Casey Carswell
• Jesus Eduardo Castaneda, DC
• Cassie J Castano, ND
• Amanda Lynn Castillo, DDS
• Christopher Castillo, LPC

• Gerontology Nurse Practitioner in Boerne, TX
• Providers in Boerne, TX by specialty
• Gerontology Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.