Heather Colleen Carroll, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2008021131 Issued in MO

Practice address

2937 S Brentwood Blvd
Brentwood, MO 63144-2713

Phone

(314) 961-3804

NPI assigned

Nov 25, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1689071367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7331 ZEPHYR PL",
            "address_2": "2E",
            "city": "MAPLEWOOD",
            "state": "MO",
            "postal_code": "631432221",
            "telephone_number": "702-375-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2937 S BRENTWOOD BLVD",
            "city": "BRENTWOOD",
            "state": "MO",
            "postal_code": "631442713",
            "telephone_number": "314-961-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "HEATHER",
        "middle_name": "COLLEEN",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-25",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2008021131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell Ray Buerck
• Eve Bufalo
• Kevin G Buhr, MPT
• Dawn Marie Carey
• Sara Xochitl Carpenter, LPC, PHD
• Angela Marie Cecil, OTR/L
• Kateri Chapman-Kramer
• Daniel John Christy, LPC
• Caroline Cioffi
• City of Brentwood

• Athletic Trainer in Brentwood, MO
• Providers in Brentwood, MO by specialty
• Athletic Trainer in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; 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.