Charles Patrick Carroll, MD

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

35038423 Issued in OH

Practice address

89 Sylvania Dr
2ND FL
Dayton, OH 45440-3237

Phone

(937) 427-8900

Fax

(937) 427-1710

NPI assigned

Jun 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499644800000",
    "number": "1780681239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 SYLVANIA DR",
            "address_2": "2ND FL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454403237",
            "telephone_number": "937-427-8900",
            "fax_number": "937-427-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 SYLVANIA DR",
            "address_2": "2ND FL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454403237",
            "telephone_number": "937-427-8900",
            "fax_number": "937-427-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "CHARLES",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2017-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35038423",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "OH",
            "license": "35038423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0436415",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashari Nicole Carr
• Kelly Lynne Carraher, CNP
• Courtney Carrier
• Isabel Carrillo
• Anisha Carrington, LPN
• Joan Renee Carroll, LICDC
• Richard Carroll, MD
• Sarah B. Carroll
• Tara M. Carroll
• Carryon Transportation LLC

• Retina Specialist (Ophthalmology) Physician in Dayton, OH
• Providers in Dayton, OH by specialty
• Retina Specialist (Ophthalmology) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2017; 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.