NPIMap

Individual provider Active NPI

Heather Elizabeth Carroll, D.O.

  • Gastroenterology Physician
  • Traverse City, MI
National Provider Identifier
1902246689
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
5101020508 Issued in MI
Practice address
4100 Park Forest Dr Ste 208
Traverse City, MI 49684-7306
Phone
(231) 935-5710
NPI assigned
Jun 26, 2013
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101020508 MI
Gastroenterology Physician 207RG0100X 5101020508 MI Primary

Addresses

Primary practice location

4100 Park Forest Dr Ste 208
Traverse City, MI 49684-7306

Mailing address

4100 Park Forest Dr Ste 208
Traverse City, MI 49684-7306
Phone (231) 935-5710

Other practice location 1

224 Park Ave
Frankfort, MI 49635-9658
Phone (231) 835-2088

Other names 1

  • Heather Elizabeth Payter Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190718001113 MI Practitioner - Gastroenterology 6103136304 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Michigan State University College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

4100 Park Forest Dr
Suite 208
Traverse City, MI 49684-7306
Phone (231) 935-5710

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy119
Upper gastrointestinal (GI) endoscopy for acid reflux198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center Current Accepting new patients
Digestive Health Associates of Northern Michigan, P.C. Gastroenterology CurrentSince Sep 1, 2019 Accepting new patients
Munson Medical Center Internal Medicine CurrentSince Jul 8, 2024 Accepting new patients
Munson Medical Center CurrentSince Jul 8, 2024 Accepting new patients
Munson Medical Center Past Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

224 Park Ave
Frankfort, MI 49635
Phone (231) 352-2200

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

4100 Park Forest Dr
Ste 208
Traverse City, MI 49684
Phone (231) 392-8705

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1902246689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR STE 208",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847306",
            "telephone_number": "231-935-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR STE 208",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847306",
            "telephone_number": "231-935-5710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Frankfort",
            "state": "MI",
            "postal_code": "496359658",
            "country_code": "US",
            "telephone_number": "231-835-2088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "HEATHER",
        "middle_name": "ELIZABETH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101020508",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "5101020508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "PAYTER",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.