Anthony Scott Carroccia, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7717 Issued in TN

Practice address

2088 Lowes Dr
Suite C
Clarksville, TN 37040-1620

Phone

(931) 648-3233

Fax

(931) 648-3266

NPI assigned

Jul 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212537600000",
    "number": "1609876572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2088 LOWES DR",
            "address_2": "SUITE C",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370401620",
            "telephone_number": "931-648-3233",
            "fax_number": "931-648-3266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2088 LOWES DR",
            "address_2": "SUITE C",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370401620",
            "telephone_number": "931-648-3233",
            "fax_number": "931-648-3266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROCCIA",
        "first_name": "ANTHONY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2008-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "7717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5440029",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL DENTAL",
            "identifier": "9176520",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Payton Elizabeth Carpenter, DPT
• Brianna Carr
• Asia Carrasco
• Joshua Joe Carrier
• Vernon M Carrigan, MD
• Marilyn J. Carroll, RN
• Donna L Carron, COTA/L
• Kristy Carron, PTA
• Paul E Carsen, PA
• Gabrielle Carsten

• General Practice Dentistry in Clarksville, TN
• Providers in Clarksville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; 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.