Carolyn Ann Ross, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1416 Issued in TN

Practice address

120 Walnut Commons LN Ste B
Cookeville, TN 38501

Phone

(931) 528-2557

Fax

(931) 526-2559

NPI assigned

Jun 16, 2005

Sex

Female

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

Other names 1

• Carolyn Ann Durham Former name

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/10383/brand/1/csg/1/fhir/r4

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.

• Cookeville Regional Medical Group, Inc

  • Multi-Specialty Clinic/Center
  • Cookeville, TN
  • NPI 1649202102
  Medicare reassignment NPD
• Medical Observation Services LLC

  • Emergency Medicine Physician
  • Cookeville, TN
  • NPI 1669734877
  NPD (past)
• Volunteer Medical Group, P.C.

  • Emergency Medicine Physician
  • Cookeville, TN
  • NPI 1801886999
  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1881699700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 DEVONSHIRE DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042318",
            "telephone_number": "931-267-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WALNUT COMMONS LN STE B",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "38501",
            "telephone_number": "931-528-2557",
            "fax_number": "931-526-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "CAROLYN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "1416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3306792",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "DURHAM",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Grant T Rohman, MD
• Mary Ann Ann Ronczkowski, MS - SLP
• Shehla Chishti Rooney, PT
• Renate Alyssa Roop, MS
• Carole Lynnett Rosenbaum, DPM
• Kyonna Ross
• Stephanie Tanya Ross, IBCLC, CLC
• Stuart Ross
• Danielle Rosser
• Stacie Rothfus, NP-C

• Family Medicine Physician in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.