Individual provider Active NPI

William Michael Carr, M.D.,F.A.A.P.

  • Pediatrics Physician
  • Stafford, VA
National Provider Identifier
1780640029
Registry record updated Nov 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101036605 Issued in VA
Practice address
385 Garrisonville Rd
Suite209
Stafford, VA 22554-1545
Phone
(540) 659-0111
Fax
(540) 720-5867
NPI assigned
Apr 25, 2006
Last updated
Nov 8, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101036605 VA Primary

Addresses

Primary practice location

385 Garrisonville Rd
Suite209
Stafford, VA 22554-1545

Mailing address

385 Garrisonville Rd
Suite209
Stafford, VA 22554-1545
Phone (540) 659-0111

Other identifiers 1

IdentifierTypeStateIssuer
1780640029MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160829002780 WA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9830321231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Stafford Pediatrics, P.C. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1780640029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 GARRISONVILLE RD",
            "address_2": "SUITE209",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225541545",
            "telephone_number": "540-659-0111",
            "fax_number": "540-720-5867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 GARRISONVILLE RD",
            "address_2": "SUITE209",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225541545",
            "telephone_number": "540-659-0111",
            "fax_number": "540-720-5867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.,F.A.A.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101036605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780640029",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

Verify at the official NPI Registry.