NPIMap

Individual provider Active NPI

Craig Grason Carroll, D.O

  • Clinical Neurophysiology Physician
  • West Chester, PA
National Provider Identifier
1861479628
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
OS13733 Issued in FL
Practice address
1694 Waterglen Dr
West Chester, PA 19382-6900
Phone
(303) 776-5298
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Electrodiagnostic Medicine Physician 204R00000X 0055838 CO
Neurology Physician 2084N0400X H0061118 MD
Neurology Physician 2084N0400X DR.55838 CO
Clinical Neurophysiology Physician 2084N0600X OS13733 FL Primary

Addresses

Primary practice location

1694 Waterglen Dr
West Chester, PA 19382-6900

Mailing address

1908 Thomes Ave Ste 12550
Cheyenne, WY 82001-3527
Phone (757) 282-3953

Other practice location 1

1908 Thomes Ave Ste 12550
Cheyenne, WY 82001-3527
Phone (303) 776-5298

Other identifiers 1

IdentifierTypeStateIssuer
0055838OtherCOLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240104000039 PA Practitioner - Neurology 7012148596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Philadelphia College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rocky Mountain Neurodiagnostics LLCGroup PAC ID 2860734597, 9 clinicians

Practice addresses (Care Compare)

West Chester, PA 19382
Phone (303) 776-5298

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0055838COMDElectrodiagnostic Medicine Physician
DR.55838COMDNeurology Physician
OS13733FLMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Neurodiagnostics, LLC Clinical Neurophysiology CurrentSince Apr 14, 2019 Accepting new patients
Bruce Katuna, MD Neurology Current Accepting new patients
Goldenrod Logistics Monitoring LLC Neurology Past Accepting new patients
Pikes Peak Neuro Care, LLC Neurology Past Accepting new patients

Locations

1619 K66
Galena, KS 66739
Phone (417) 347-7272

1908 Thomes Ave
Ste 12550
Cheyenne, WY 82001

Organizations & group practices 4

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1861479628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 THOMES AVE STE 12550",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013527",
            "telephone_number": "757-282-3953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1694 WATERGLEN DR",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193826900",
            "telephone_number": "303-776-5298"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1908 Thomes Ave Ste 12550",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820013527",
            "country_code": "US",
            "telephone_number": "303-776-5298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "CRAIG",
        "middle_name": "GRASON",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204R00000X",
            "taxonomy_group": "",
            "desc": "Electrodiagnostic Medicine",
            "state": "CO",
            "license": "0055838",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MD",
            "license": "H0061118",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CO",
            "license": "DR.55838",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "FL",
            "license": "OS13733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0055838",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.