Erin Jones Carroll, PA-C
Individual provider Active NPI Medical Physician Assistant · Eden, NC
NPI 1891090874 · NPPES record last updated Nov 12, 2013
Key facts
- NPI
- 1891090874
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 0010-02828 (NC)
- Practice address
- 250 W Kings Hwy
Eden, NC 27288-5010 - Phone
- (336) 623-5171
- NPI assigned
- Jan 21, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110405000811 | NC | Practitioner - Physician Assistant | 6709060478 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-02828 | NC | MD | Medical Physician Assistant |
| 0110003500 | VA | MD | Medical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0110003500 | VA | |
| Medical Physician Assistant | 363AM0700X | 0010-02828 | NC | Yes |
Addresses
Primary practice location
250 W Kings Hwy
Eden, NC 27288-5010
Mailing address
250 W Kings Hwy
Eden, NC 27288
Phone (336) 623-5171
Other providers in Eden, NC
- Care of Diversity, LLC
- Carolina Apothecary Inc
- Carolina Prime Residential LLC
- Aaron Carpenter
- Joe Gray Carpenter
- Kelsey Carter
- Angel G Cassell
- Reginald Cathey
- Central Care Division, LLC
- Central Care Division, LLC
All providers in Eden, NC · Medical Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.