Active NPI
Neil K Carroll, ATC
- Athletic Trainer
- South Portland, ME
National Provider Identifier
1871534180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT244
- Practice address
- 100 Brickhill Ave
Suite 303
South Portland, ME 04106-1999 - Phone
- (207) 773-0040
- Fax
- (207) 774-6501
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT244 | ME | Primary |
Addresses
Primary practice location
100 Brickhill Ave
Suite 303
South Portland, ME 04106-1999
Mailing address
100 Brickhill Ave
Suite 303
South Portland, ME 04106-1999
Phone (207) 773-0040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT244 | ME | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404950400000",
"number": "1871534180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 BRICKHILL AVE",
"address_2": "SUITE 303",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041061999",
"telephone_number": "207-773-0040",
"fax_number": "207-774-6501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 BRICKHILL AVE",
"address_2": "SUITE 303",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041061999",
"telephone_number": "207-773-0040",
"fax_number": "207-774-6501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "NEIL",
"middle_name": "K",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2014-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ME",
"license": "AT244",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.