Brian Glenn McCarroll, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501019674 Issued in MI

Practice address

14626 23 Mile Rd
Shelby Township, MI 48315-3000

Phone

(586) 733-0561

NPI assigned

Oct 20, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 9

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Duke University School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Physical Therapy IncGroup PAC ID 0941228548, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Advanced Physical Therapy Inc

  • Physical Therapist
  • Anchorage, AK
  • NPI 1437214459

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Quality Care Rehabilitation Professionals

  • Occupational Therapist
  • Shelby Township, MI
  • NPI 1437718830

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1922607183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7605 FLICKINGER DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483172337",
            "telephone_number": "586-733-0561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14626 23 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153000",
            "telephone_number": "586-733-0561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARROLL",
        "first_name": "BRIAN",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-20",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251E1200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Ergonomics",
            "state": "MI",
            "license": "5501019674",
            "primary": false
        },
        {
            "code": "2251E1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Electrophysiology, Clinical",
            "state": "MI",
            "license": "5501019674",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "MI",
            "license": "5501019674",
            "primary": false
        },
        {
            "code": "2251H1300X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Human Factors",
            "state": "MI",
            "license": "5501019674",
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "MI",
            "license": "5501019674",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MI",
            "license": "5501019674",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "MI",
            "license": "5501019674",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MI",
            "license": "5501019674",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "PTEverywhere",
            "affiliation": "N",
            "endpointDescription": "Online portal",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "14626 23 Mile Rd",
            "city": "Shelby Township",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483153000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anila Mathew
• Victoria Matovski
• Ariana Patricia Matway, DDS
• Liane Joy Maxwell, OT
• Austin Mayer
• Claudine McCormick, PTA
• Kaneisha McCray
• Edward Carlton McCuiston III, D.C.
• Sandra McCuiston, D.C.
• Katlyn McDonald, PTA

• Physical Therapist in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.