Carol Lynn Croll, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501007018 Issued in MI

Practice address

1129 Calpernia
Wixom, MI 48393-4506

Phone

(248) 761-7380

NPI assigned

Mar 10, 2014

Sex

Female

Sole proprietor

Yes

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, last updated by the provider on Apr 15, 2014.

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1689090045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 CALPERNIA",
            "city": "WIXOM",
            "state": "MI",
            "postal_code": "483934506",
            "telephone_number": "248-761-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 CALPERNIA",
            "city": "WIXOM",
            "state": "MI",
            "postal_code": "483934506",
            "telephone_number": "248-761-7380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROLL",
        "first_name": "CAROL",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-10",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501007018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Wixom, MI
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.