Carrollton Ear, Nose and Throat, P.C.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

CARROLLTON EAR, NOSE AND THROAT, P.C.

Practice address

150 Clinic Ave
Suite 201
Carrollton, GA 30117-4401

Phone

(770) 832-1488

NPI assigned

Jun 29, 2006

Organization subpart

No

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

Authorized official

Name

Vicki Williamson

Title

Administrator

Phone

(770) 832-1488

Specialties & licenses 1

Addresses

Other names 1

• Carrollton Ear, Nose and Throat Other name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William Bradley Gambrell, M.D.

  • Otolaryngology Physician
  • Carrollton, GA
  • NPI 1013056985
  Medicare reassignment NPD
• L Mark Gustafson, M.D.

  • Otolaryngology Physician
  • Carrollton, GA
  • NPI 1073555629
  Medicare reassignment NPD
• Christopher W. Harper Jr., MD

  • Otolaryngology Physician
  • Carrollton, GA
  • NPI 1407201486
  Medicare reassignment NPD
• Nicollette McKinnon, FNP-C

  • Family Nurse Practitioner
  • Carrollton, GA
  • NPI 1518413475
  Medicare reassignment NPD
• John C Pezold, M.D.

  • Otolaryngology Physician
  • Carrollton, GA
  • NPI 1245272806
  Medicare reassignment NPD
• Amy Rowell, FNP-C

  • Family Nurse Practitioner
  • Carrollton, GA
  • NPI 1760023972
  Medicare reassignment NPD
• Elizabeth Kentra-Gorey, M.D.

  • Otolaryngology Physician
  • Deerfield Beach, FL
  • NPI 1649212341

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1760410401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CLINIC AVE",
            "address_2": "SUITE 201",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174401",
            "telephone_number": "770-832-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CLINIC AVE",
            "address_2": "SUITE 201",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174401",
            "telephone_number": "770-832-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLLTON EAR, NOSE AND THROAT, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-832-1488"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carrollton Ear, Nose and Throat",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Otolaryngology Physician in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Otolaryngology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.