Kim Carroll, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

498 Issued in NC

Practice address

205 S Enterprize Pkwy
Corpus Christi, TX 78405-4118

Phone

(361) 939-6510

Fax

(361) 939-6511

NPI assigned

Oct 6, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1902893720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S ENTERPRIZE PKWY",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784054118",
            "telephone_number": "361-939-6510",
            "fax_number": "361-939-6511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S ENTERPRIZE PKWY",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784054118",
            "telephone_number": "361-939-6510",
            "fax_number": "361-939-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "081A1",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902315",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00634269",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriella Victoria Carrillo
• Mia Carrillo
• Jessica Elvira Carrion
• Carroll Ann Williams LLC
• John Raymond Carroll, MD
• Cynthia G Carson, PT
• Camille Ray Carter-Kitchen, LCSW
• Christine Marie Carter, M.S.CCC/SLP
• Debrina Mariah Carter X
• Lindsey Carter, MS, CCC-SLP

• Foot & Ankle Surgery Podiatrist in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Foot & Ankle Surgery Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.