John Michael Carroll, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

18687 Issued in SC

Practice address

6108 Garners Ferry Rd
Columbia, SC 29209-1401

Phone

(803) 647-1265

Fax

(803) 647-1266

NPI assigned

Jan 23, 2006

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: john.carroll@smpsc.eclinicaldirectplus.com

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.

• Southern Medical Management, LLC

  • Pediatrics Physician
  • Lexington, SC
  • NPI 1114196557
  NPD (past)
• Sweetgrass Pediatrics

  • Pediatrics Physician
  • North Charleston, SC
  • NPI 1437168135
  NPD (past)

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292284800000",
    "number": "1669442869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6108 GARNERS FERRY RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091401",
            "telephone_number": "803-647-1265",
            "fax_number": "803-647-1266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6108 GARNERS FERRY RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091401",
            "telephone_number": "803-647-1265",
            "fax_number": "803-647-1266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2010-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "18687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186872",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Carrigan
• Alexis Carrington
• Omysha Carrington
• Carroll Orthodontics , P.C.
• Christine Carroll, PA
• Robert Carroll, DMD
• Tara P Carroll, MCD, CCC/A
• Rhonwyn Carson-Moore, PHD
• Virginia Carson, R.PH.
• Ryan Brad Carsten

• Pediatrics Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.