Mary Joanne Carroll

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

201240456RN Issued in OR

Practice address

3355 Chad Dr
Eugene, OR 97408-7428

Phone

(541) 607-0897

NPI assigned

May 24, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1821736463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 572",
            "city": "CRESWELL",
            "state": "OR",
            "postal_code": "974260572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 CHAD DR",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974087428",
            "telephone_number": "541-607-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MARY",
        "middle_name": "JOANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "408509",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201240456RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maja Diane Carrel
• Michael Louis Carrizales, PSY.D.
• Barbara Carroll, CRNA
• Christina Elyce Carroll
• Kyra D. Carroll, CCC-SLP
• Rebecca May Carroll, MD
• Carrie Ann Carso
• Megan Rachelle Carson
• Raaata Carter Johnson
• Julie Ann Carter

• Registered Nurse in Eugene, OR
• Providers in Eugene, OR by specialty
• Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; 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.