Richard Peyton Carroll Jr., D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OP00002292 Issued in WA

Practice address

14508 NE 20TH Ave
Suite 102
Vancouver, WA 98686-6424

Phone

(360) 574-9730

Fax

(360) 576-7662

NPI assigned

Oct 20, 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Great West Family Care PC

  • Primary Care Clinic/Center
  • Vancouver, WA
  • NPI 1427073840

  Family Medicine

  NPD (past)
• Ridgefield Family Medicine, PLLC

  • Family Medicine Physician
  • Ridgefield, WA
  • NPI 1407229719
  NPD (past)
• Oak Grove Family Medical Clinic P C

  • Family Medicine Physician
  • Milwaukie, OR
  • NPI 1346218369
  NPD (past)

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1619966744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14508 NE 20TH AVE",
            "address_2": "SUITE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866424",
            "telephone_number": "360-574-9730",
            "fax_number": "360-576-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14508 NE 20TH AVE",
            "address_2": "SUITE 102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866424",
            "telephone_number": "360-574-9730",
            "fax_number": "360-576-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "RICHARD",
        "middle_name": "PEYTON",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00002292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8499824",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reynard Carrie Jr.
• Kelsey Anne Carrier
• Angelina Carrion-Epps
• Todd Crew Carris, DMD
• Melissa Day Carroll, LICSW
• Jeffrey Michael Carse
• Christopher E. Carson, P.A.-C.
• Phillip Carson, CDPT
• Emily Carsten
• Barbara Jo Carter, P.T.

• Family Medicine Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.