Individual provider Active NPI

John Carrill, M.D.

  • Psychiatry Physician
  • Hagerstown, MD
National Provider Identifier
1821063124
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D18559 Issued in MD
Practice address
13215 Brook Lane
Hagerstown, MD 21742
Phone
(301) 733-0330
Fax
(301) 733-4038
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X D18559 MD Primary

Addresses

Primary practice location

13215 Brook Lane
Hagerstown, MD 21742

Mailing address

13121 Brook Lane
Hagerstown, MD 21742
Phone (301) 733-0330

Other practice location 1

18714 N Village
Hagerstown, MD 21742-2454
Phone (301) 733-0330

Other identifiers 1

IdentifierTypeStateIssuer
409491301MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brook Lane Health Services, Inc. CurrentSince Aug 1, 2007 Accepting new patients
Brook Lane Behavioral Services, Inc. Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4540 Mack Ave
Ste B
Frederick, MD 21703
Phone (301) 698-5665

13218 Brooklane Dr
Hagerstown, MD 21742
Phone 3017330330184

18714 North Village
Hagerstown, MD 21742
Phone (301) 733-0331

Organizations & group practices 3

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1821063124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13121 BROOK LANE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "21742",
            "telephone_number": "301-733-0330",
            "fax_number": "301-733-4038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13215 BROOK LANE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "21742",
            "telephone_number": "301-733-0330",
            "fax_number": "301-733-4038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18714 N Village",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217422454",
            "country_code": "US",
            "telephone_number": "301-733-0330",
            "fax_number": "301-733-4038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRILL",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D18559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "409491301",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.