Active NPI
Joellen Carroll
- Physical Therapist
- Wilson, NC
National Provider Identifier
1730734757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P4234
- Practice address
- 1705 Tarboro St SW
Wilson, NC 27893-3428 - Phone
- (252) 399-8998
- NPI assigned
- Aug 6, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | P4234 | NC | Primary |
Addresses
Primary practice location
1705 Tarboro St SW
Wilson, NC 27893-3428
Mailing address
4808 Country Club Dr N
Wilson, NC 27896-9118
Phone (252) 292-1853
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P4234 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565049600000",
"number": "1730734757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4808 COUNTRY CLUB DR N",
"city": "WILSON",
"state": "NC",
"postal_code": "278969118",
"telephone_number": "252-292-1853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 TARBORO ST SW",
"city": "WILSON",
"state": "NC",
"postal_code": "278933428",
"telephone_number": "252-399-8998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "JOELLEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-06",
"last_updated": "2019-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P4234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilson, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.