Individual provider Active NPI

Dawne Maria Carroll, M.D.

  • Family Medicine Physician
  • Bowie, MD
National Provider Identifier
1902917628
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0042719 Issued in MD
Practice address
14408 Woodmore Oaks CT
Bowie, MD 20721-1910
Phone
(301) 818-1243
Fax
(240) 435-2692
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101041759 VA
Family Medicine Physician 207Q00000X MD16892 DC
Family Medicine Physician 207Q00000X D0042719 MD Primary
General Acute Care Hospital 282N00000X D0042719 MD
General Acute Care Hospital 282N00000X MD16892 DC

Addresses

Primary practice location

14408 Woodmore Oaks CT
Bowie, MD 20721-1910

Mailing address

12138 Central Ave Ste 953
Bowie, MD 20721-1910
Phone (301) 818-1243

Other identifiers 4

IdentifierTypeStateIssuer
032383200MedicaidDC
182901700MedicaidMD
010001331MedicaidVA
523329100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, MD3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20041027000033 DC Practitioner - Family PracticePractitioner - General PracticePractitioner - Emergency Medicine 9739140070 Practice locations: Mitchellville, MD
I20130321000642 VA Practitioner - Family PracticePractitioner - Emergency Medicine 9739140070 Reassigns benefits to 2 organizations
I20150710001404 MD Practitioner - Emergency Medicine 9739140070 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD16892DCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage, LLC Family Medicine CurrentSince Feb 15, 2013 Accepting new patients
Fit for Life Medical Center Inc Family Medicine CurrentSince Jan 1, 1997 Accepting new patients
Eastern Shore Emergency Medicine Physicians, LLC Past Accepting new patients
National Emergency Services District of Columbia Inc Past Accepting new patients
Frederick Health Hospital Inc General Acute Care Hospital Past Accepting new patients

Locations

14300 Gallant Fox Ln
Ste 118
Bowie, MD 20715
Phone (301) 464-3020

12138 Central Ave
Mitchellville, MD 20721
Phone (240) 636-1663

1 Arh Ln
Low Moor, VA 24457
Phone (540) 862-6223

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1902917628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12138 CENTRAL AVE STE 953",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207211910",
            "telephone_number": "301-818-1243",
            "fax_number": "240-435-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14408 WOODMORE OAKS CT",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207211910",
            "telephone_number": "301-818-1243",
            "fax_number": "240-435-2692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "DAWNE",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101041759",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD16892",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0042719",
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MD",
            "license": "D0042719",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "DC",
            "license": "MD16892",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032383200",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182901700",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010001331",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "523329100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.