Individual provider Active NPI

Laura M Carroll, PT

  • Physical Therapist
  • West Lafayette, IN
National Provider Identifier
1700048121
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05008476A Issued in IN
Practice address
152 Sagamore Pkwy W
West Lafayette, IN 47906-1569
Phone
(765) 463-2200
Fax
(765) 463-3625
NPI assigned
Jun 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05008476A IN Primary
Physical Therapist 225100000X 8099 AZ

Addresses

Primary practice location

152 Sagamore Pkwy W
West Lafayette, IN 47906-1569

Mailing address

PO Box 4699
Lafayette, IN 47903-4699
Phone (765) 449-2732

Other practice location 1

3806 Amelia Ave
Lafayette, IN 47905-5772
Phone (765) 807-2773

Other practice location 2

424 W Division St
Remington, IN 47977-8715
Phone (765) 807-2773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160812001303 IN Practitioner - Physical Therapist in Private Practice 6204900632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Miracles Rehabilitation LLCGroup PAC ID 2567998750, 10 clinicians

Practice addresses (Care Compare)

152 Sagamore Pkwy W
West Lafayette, IN 47906-1569
Phone (765) 463-2200

3806 Amelia Ave
Lafayette, IN 47905-5772
Phone (765) 807-2773

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8099AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carroll Pelvic Health and Wellness, LLC Physical Therapist Current Accepting new patients
Miracles Rehabilitation LLC Physical Therapist CurrentSince Feb 1, 2025 Accepting new patients
Armendariz Medical Associates LLC Past Accepting new patients
Arizona Vulva Clinic, PLLC Past Accepting new patients

Locations

3806 Amelia Ave
Lafayette, IN 47905
Phone (765) 807-2773

424 W Division St
Remington, IN 47977
Phone (765) 807-2773

152 Sagamore Pkwy W
West Lafayette, IN 47906
Phone (765) 423-6556

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1700048121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4699",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479034699",
            "telephone_number": "765-449-2732",
            "fax_number": "765-449-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 SAGAMORE PKWY W",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479061569",
            "telephone_number": "765-463-2200",
            "fax_number": "765-463-3625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3806 Amelia Ave",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479055772",
            "country_code": "US",
            "telephone_number": "765-807-2773",
            "fax_number": "765-807-2774",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "424 W Division St",
            "address_purpose": "LOCATION",
            "city": "Remington",
            "state": "IN",
            "postal_code": "479778715",
            "country_code": "US",
            "telephone_number": "765-807-2773",
            "fax_number": "765-807-2774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "LAURA",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05008476A",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "8099",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.