Robert Morton Carroll X, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

C28429 Issued in CA

Practice address

2241 Century HL
Los Angeles, CA 90067-3506

Phone

(310) 435-1772

NPI assigned

Apr 9, 2020

Last updated

Apr 9, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1881213817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2241 CENTURY HL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900673506",
            "telephone_number": "310-435-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2241 CENTURY HL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900673506",
            "telephone_number": "310-435-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "ROBERT",
        "middle_name": "MORTON",
        "name_suffix": "X",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "C28429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THANKS",
            "identifier": "C28429",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Alexandria Carroll
• Joshua Carroll, LMFT
• Leah Dawn Carroll, MSW
• Matthew Carroll
• Nicole Ryan Carroll
• Robert Steven Carroll, MD
• Shari Hope Carroll, DMD, MPH
• Thaddeus Cornelius Carroll
• William Carroll
• Xavier Carroll

• Vascular Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; 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.