Traci Carroll, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0101250370 Issued in VA

Practice address

Corner of Lamont Street and Veterans Way
Mountain Home, TN 37684

Phone

(423) 926-1171

NPI assigned

Mar 30, 2010

Last updated

Aug 18, 2014By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408320000000",
    "number": "1700101037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4000",
            "address_2": "MOUNTAIN HOME VETERANS ADMINISTRATION MEDICAL CENTER",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "37684",
            "telephone_number": "423-926-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF LAMONT STREET AND VETERANS WAY",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "37684",
            "telephone_number": "423-926-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "TRACI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-30",
        "last_updated": "2014-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101250370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Edward Bush, M.D.
• Ryland Pratt Byrd, M.D.
• Doris K. Call, LCSW
• Teresa A Campbell, M.D.
• Tara Carroll
• Sarah Elizabeth Carter, LPC-MHSP
• Brian Michael Cartwright, MD
• Stephanie Michelle Castlewhite, MD
• Cynthia R Chapman, CMSW
• Kelli Michelle Chaulk Johnson, MS CCC-SLP

• Psychiatry Physician in Mountain Home, TN
• Providers in Mountain Home, TN by specialty
• Psychiatry Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.