Theresa A Carroll, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305206103 Issued in VA

Practice address

2106 Executive Dr
Hampton, VA 23666-2402

Phone

(757) 838-6678

Fax

(757) 838-8116

NPI assigned

Aug 4, 2009

Sex

Female

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256601600000",
    "number": "1679704951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 PILOT HOUSE DR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236061990",
            "telephone_number": "757-873-2302",
            "fax_number": "757-873-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 EXECUTIVE DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662402",
            "telephone_number": "757-838-6678",
            "fax_number": "757-838-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "THERESA",
        "middle_name": "A",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-04",
        "last_updated": "2009-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305206103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679704951",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00748138",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9409378",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela C Carrecter, LCSW
• Bertha Theresia Carrelli, LCSW
• Lucy Carrig
• Crystal Carrington, LPC
• Nicole Carrington
• Keiva Carstarphen-Sturdivant, PHARMD
• Christina Rochelle Carter, NP
• Lauren B Carter, MA, CCC-SLP
• Leo Rondus Carter, M.D.
• Margareta Marie Carter, LCSW

• Physical Therapist in Hampton, VA
• Providers in Hampton, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; 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.