Active NPI
Iesha Carroll, PHARMD
- Pharmacist
- D'Iberville, MS
National Provider Identifier
1922613413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E-15121
- Practice address
- 12007 Lamey Bridge Rd
Diberville, MS 39540-8907 - Phone
- (228) 392-2388
- NPI assigned
- Sep 10, 2020
- Last updated
- Sep 10, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E-15121 | MS | Primary |
Addresses
Primary practice location
12007 Lamey Bridge Rd
Diberville, MS 39540-8907
Mailing address
12007 Lamey Bridge Rd
Diberville, MS 39540-8907
Phone (228) 392-2388
Other names 1
- Dr. Iesha Carroll
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-15121 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
12007 Lamey Bridge Rd
Diberville, MS 39540
Phone (228) 392-2388
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599696000000",
"number": "1922613413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12007 LAMEY BRIDGE RD",
"city": "DIBERVILLE",
"state": "MS",
"postal_code": "395408907",
"telephone_number": "228-392-2388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12007 LAMEY BRIDGE RD",
"city": "DIBERVILLE",
"state": "MS",
"postal_code": "395408907",
"telephone_number": "228-392-2388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "IESHA",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-10",
"last_updated": "2020-09-10",
"certification_date": "2020-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E-15121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "IESHA",
"last_name": "CARROLL",
"prefix": "DR.",
"credential": "PHARMD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in D'Iberville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.