Michael G Carroll, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

16212 Issued in KY

Practice address

1460 Bluegrass Ave
Louisville, KY 40215-1272

Phone

(502) 361-8496

Fax

(502) 361-3377

NPI assigned

Jul 28, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Hospital Internal Medicine Associates, PLLC

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1962423285
  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1609876978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 DIXIE HWY",
            "address_2": "SUITE 130",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402583913",
            "telephone_number": "502-361-8496",
            "fax_number": "502-361-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 BLUEGRASS AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151272",
            "telephone_number": "502-361-8496",
            "fax_number": "502-361-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "KY",
            "license": "16212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6590070600",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100003350",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Otis Carroll, DMD
• Kathleen J. Carroll, LCSW
• Kelsey Carroll, APRN
• Laura Carroll, COTA/L
• Mackenzie Elizabeth Carroll
• Patrick Michael Carroll, DMD
• Sarah Carroll, APRN
• Thomas John Carroll III, PHARMD
• Tonya Ann Carroll
• Travis Carroll

• Hematology & Oncology Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Hematology & Oncology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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.