Jennie Carroll, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP133656 Issued in TX

Practice address

11307 FM 1960 Rd W Ste 130
Houston, TX 77065-4918

Phone

(281) 469-9955

Fax

(832) 912-4083

NPI assigned

Jun 5, 2017

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bear Creek Pediatric Clinic PA

  • Pediatrics Physician
  • Houston, TX
  • NPI 1528050150

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1891224721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14934 RUSSET BEND LN",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774298527",
            "telephone_number": "281-610-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11307 FM 1960 RD W STE 130",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770654918",
            "telephone_number": "281-469-9955",
            "fax_number": "832-912-4083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4654 Highway 6 N Ste 307",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770842879",
            "country_code": "US",
            "telephone_number": "281-463-9339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JENNIE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP133656",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP133656",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camille Bridget Carroll, MD
• Cole Randa; Carroll, LCDC-I
• Don E. Carroll Jr., DDS
• Emma Alexandra Carroll, M.D.
• Giovanna R Carroll, LPC
• L Natalie Carroll, MD P A
• Maridel Opada Carroll, ANP-BC
• Matthew Carroll
• Michelle Carroll, AGACNP-BC
• Reagan Carroll

• Family Nurse Practitioner in Houston, TX
• Providers in Houston, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.