Kathleen Mary Carroll, NURSE PRACTITIONER

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

148085 Issued in MA

Practice address

5 Industrial Drive Rogers Outpatient Center
Suite 100
Mashpee, MA 02649

Phone

(508) 477-4272

Fax

(508) 539-6134

NPI assigned

Feb 21, 2007

Last updated

May 28, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1851436059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 INDUSTRIAL DRIVE ROGERS OUTPATIENT CENTER",
            "address_2": "MASHPEE FAMILY MEDICINE SUITE 100",
            "city": "MASHPEE",
            "state": "MA",
            "postal_code": "02649",
            "telephone_number": "508-477-4282",
            "fax_number": "508-539-6134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 INDUSTRIAL DRIVE ROGERS OUTPATIENT CENTER",
            "address_2": "SUITE 100",
            "city": "MASHPEE",
            "state": "MA",
            "postal_code": "02649",
            "telephone_number": "508-477-4272",
            "fax_number": "508-539-6134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "KATHLEEN",
        "middle_name": "MARY",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "148085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cape Therapy Network, LLC (Cape Kids Therapy & Sensory Center)
• John Christopher Carr, R PH
• Carroll Physical Therapy (Cape Cod Rehabilitation)
• Jonathan Carroll, D.P.T.
• Joseph Carroll, PT
• Kathryn Carroll, PT
• David Carter, MACOM
• Sarah Rachel Carvalho
• Megan Ann Cavanaugh, RN
• Sandra Chagaris

• Adult Health Nurse Practitioner in Mashpee, MA
• Providers in Mashpee, MA by specialty
• Adult Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; 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.