Individual provider Active NPI

Marisa Louise Carroll

  • Technician
  • Bay City, MI
National Provider Identifier
1730852872
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
TechnicianTaxonomy code 374700000X
Practice address
3727 Wilder Rd
Bay City, MI 48706-2367
Phone
(989) 860-5176
NPI assigned
Jul 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Technician 374700000X MI Primary

Addresses

Primary practice location

3727 Wilder Rd
Bay City, MI 48706-2367

Mailing address

7110 Michigan Rd
Bay City, MI 48706-9310

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

Practice roles

OrganizationSpecialtyStatusNew patients
Game Changer Pediatric Therapy Services LLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

3727 Wilder Rd
Bay City, MI 48706
Phone (989) 860-1425

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.

NPI Registry JSON

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1730852872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7110 MICHIGAN RD",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487069310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3727 WILDER RD",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487062367",
            "telephone_number": "989-860-5176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MARISA",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.