NPIMap

Individual provider Active NPI

Stephanie L Carroll, MD

  • Internal Medicine Physician
  • La Crosse, WI
National Provider Identifier
1942205356
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
47506 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Jun 14, 2005
Last updated
Jan 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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 47506 WI Primary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 47506 WI

Addresses

Primary practice location

1836 South Ave
La Crosse, WI 54601-5429

Mailing address

1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Other identifiers 1

IdentifierTypeStateIssuer
34613200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20050210000352 WI Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 0345292033 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospice/Palliative Care
Education
Medical College of Wisconsin, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tri-County Memorial Hospital IncGroup PAC ID 4587642418, shared by 5 NPIs, 75 clinicians

Practice addresses (Care Compare)

18601 Lincoln St
Whitehall, WI 54773-8605
Phone (715) 538-4361

1910 S Ave
La Crosse, WI 54601-5467
Phone (608) 782-7300

402 W Lake St
Friendship, WI 53934-9699
Phone (608) 339-3331

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47506WIMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Express Care, Inc CurrentSince Feb 1, 2005 Accepting new patients
Tri-County Memorial Hospital, Inc. CurrentSince Sep 29, 2018 Accepting new patients
St. Joseph's Health Services, Inc. Current Accepting new patients
Tri-County Memorial Hospital, Inc. CurrentSince Sep 29, 2018 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Jun 1, 2013 Accepting new patients
Tri-County Memorial Hospital, Inc. Hospice and Palliative Medicine Current Accepting new patients
Memorial Hospital of Boscobel CurrentSince Jan 25, 2026 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc. CurrentSince Jul 1, 2019 Accepting new patients
St. Joseph's Health Services, Inc. Hospice and Palliative Medicine CurrentSince Mar 10, 2020 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc Internal Medicine CurrentSince Jan 4, 2026 Accepting new patients
Memorial Hospital of Boscobel CurrentSince Jan 25, 2026 Accepting new patients
Gundersen Clinic LTD CurrentSince Feb 1, 2005 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Jun 1, 2013 Accepting new patients
St. Joseph's Health Services, Inc Hospice and Palliative Medicine CurrentSince Mar 10, 2020 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc. Hospice and Palliative Medicine CurrentSince Jul 1, 2019 Accepting new patients

Locations

205 Parker St
Boscobel, WI 53805
Phone (608) 375-4112

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1600 Main St
Onalaska, WI 54650
Phone (608) 783-4681

610 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 326-6466

18601 Lincoln St
Whitehall, WI 54773
Phone (715) 538-1712

Interoperability endpoints

  • Direct secure messaging: scarroll9964@direct.emplifyhealth.org

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Gundersen Moundview Hospital and ClinicsFriendship, WI, CCN 52Z309 Hospital Corporate Director Jul 13, 2020
Gundersen Moundview Hospital and ClinicsFriendship, WI, CCN 521309 Hospital Corporate Director Jul 13, 2020
Gundersen Moundview Hospital and ClinicsFriendship, WI, CCN 528520 Rural health clinic Corporate Director Jul 13, 2020
Gundersen Lansing ClinicLansing, IA, CCN 163892 Rural health clinic Corporate Director Jan 1, 2025
Moundview Memorial Hospital & Clinics, Inc.Westfield, WI, CCN 528603 Rural health clinic Corporate Director Jul 13, 2020

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 11

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1942205356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-14",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "47506",
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "WI",
            "license": "47506",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34613200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.