Carolyn Ricketts, RDCS, RDMS, RVT, ARR
Individual provider Active NPI Vascular Sonography Radiologic Technologist · MC Minnville, TN
NPI 1790728293 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1790728293
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Vascular Sonography Radiologic Technologist 2471V0105X
- License
- 10577 (TN)
- Practice address
- 9022 Lucky Rd
MC Minnville, TN 37110-4486 - Phone
- (931) 934-2020
- Fax
- (931) 934-2026
- NPI assigned
- Jun 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 079866 | TN | MD | Radiography Radiologic Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| R & R Imaging, Inc | Sonography | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sonography Specialist/Technologist Cardiovascular | 246XS1301X | 10577 | TN | |
| Radiography Radiologic Technologist | 2471C3402X | 079866 | TN | |
| Sonography Radiologic Technologist | 2471S1302X | 10577 | TN | |
| Vascular Sonography Radiologic Technologist | 2471V0105X | 10577 | TN | Yes |
Addresses
Primary practice location
9022 Lucky Rd
MC Minnville, TN 37110-4486
Mailing address
9022 Lucky Rd
MC Minnville, TN 37110-4486
Phone (931) 934-2020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3790225 | Medicaid | TN | |
| 4017629 | Other | TN | BLUE CROSS BLUE SHIELD |
Other providers in MC Minnville, TN
- R. P. Sabo, M.D., P.C.
- Raintree Investments & Associates, LLC
- Kalpana Hitesh Rajdev
- Randal Don Rampp
- Restorative Health Services, Inc.
- River Park Hospital Inc
- River Park Hospital LLC
- River Park Hospital LLC
- River Park Hospital LLC
- River Park Physician Group LLC
All providers in MC Minnville, TN · Vascular Sonography Radiologic Technologist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.