Active NPI
Caroline Reilly Carroll, PA-C
- Physician Assistant
- Cincinnati, OH
National Provider Identifier
1699269415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 50.007661
- Practice address
- 3333 Burnet Ave
Cincinnati, OH 45229-3026 - Phone
- (513) 636-4200
- NPI assigned
- Jun 15, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA031457 | DC | |
| Physician Assistant | 363A00000X | 0010-08032 | NC | |
| Physician Assistant | 363A00000X | 50.007661 | OH | Primary |
Addresses
Primary practice location
3333 Burnet Ave
Cincinnati, OH 45229-3026
Mailing address
3333 Burnet Ave
Cincinnati, OH 45229-3026
Other practice location 1
111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-4177
Other practice location 2
1310 Southern Ave SE
Washington, DC 20032-4623
Phone (202) 574-7070
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-08032 | NC | MD | Physician Assistant |
| 50.007661 | OH | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Children's Hospital
- Washington, DC
- NPI 1912939703
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697155200000",
"number": "1699269415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 BURNET AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452293026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 BURNET AVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452293026",
"telephone_number": "513-636-4200"
}
],
"practiceLocations": [
{
"address_1": "111 Michigan Ave NW",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "20010",
"country_code": "US",
"telephone_number": "202-476-4177",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1310 Southern Ave SE",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200324623",
"country_code": "US",
"telephone_number": "202-574-7070",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARROLL",
"first_name": "CAROLINE",
"middle_name": "REILLY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-15",
"last_updated": "2023-10-13",
"certification_date": "2023-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "DC",
"license": "PA031457",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-08032",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OH",
"license": "50.007661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.