Individual provider Active NPI

David Carroll, AGACNP-BC

  • Gerontology Nurse Practitioner
  • Warwick, RI
National Provider Identifier
1487481099
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN042187 Issued in RI
Practice address
660 Commonwealth Ave
Warwick, RI 02886-2707
Phone
(401) 418-0964
NPI assigned
Sep 17, 2024
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN042187 RI Primary

Addresses

Primary practice location

660 Commonwealth Ave
Warwick, RI 02886-2707

Mailing address

141 Brookwood Rd
Warwick, RI 02889-3218
Phone (401) 418-0964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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

Enrollment IDStateProvider typePAC IDDetails
I20240926003693 RI Practitioner - Nurse Practitioner 7012448319 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN042187RIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alignmed Medical Group, PC CurrentSince Sep 14, 2024 Accepting new patients
Alignmed Partners, PC CurrentSince Sep 17, 2024 Accepting new patients
GPS Physician Group of Rhode Island PC CurrentSince Sep 17, 2024 Accepting new patients

Locations

10 Woodland Dr
Coventry, RI 02816
Phone (401) 438-3250

660 Commonwealth Ave
Warwick, RI 02886
Phone (401) 691-4511

1139 Main Ave
Warwick, RI 02886
Phone (401) 739-6600

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": "1726531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1487481099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 BROOKWOOD RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028893218",
            "telephone_number": "401-418-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 COMMONWEALTH AVE",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862707",
            "telephone_number": "401-418-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "DAVID",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "RI",
            "license": "APRN042187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.