Individual provider Active NPI

Lee Gordon Carroll, CRNA

  • Certified Registered Nurse Anesthetist
  • Towson, MD
National Provider Identifier
1942490610
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R144380 Issued in MD
Practice address
6701 N Charles St
Towson, MD 21204-6808
Phone
(410) 296-4616
Fax
(410) 337-5068
NPI assigned
Jul 30, 2007
Last updated
Oct 25, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R144380 MD Primary

Addresses

Primary practice location

6701 N Charles St
Towson, MD 21204-6808

Mailing address

110 West Rd Ste 210
Towson, MD 21204-2341
Phone (410) 296-4616

Other identifiers 1

IdentifierTypeStateIssuer
R144380OtherSTATE LICENCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071009000793 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163518960 Reassigns benefits to 7 organizations
I20181119002362 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163518960 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R144380MDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia Maryland LLC CurrentSince Sep 6, 2021 Accepting new patients
Maryland Expresscare LLC CurrentSince Jan 12, 2016 Accepting new patients
Johns Hopkins University Nurse Anesthetist, Certified Registered CurrentSince Jan 14, 2020 Accepting new patients
Johns Hopkins University CurrentSince Jan 14, 2020 Accepting new patients
University of Maryland Medical System Corporation Nurse Anesthetist, Certified Registered CurrentSince Jan 12, 2016 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Mar 1, 2018 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Mar 1, 2018 Accepting new patients
GBMC Hospital Based Services, LLC. CurrentSince Dec 25, 2023 Accepting new patients
First Colonies Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 21, 2017 Accepting new patients
Johns Hopkins University Current Accepting new patients
American Anesthesiology of Maryland, P.C. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

201 E University Pkwy
Baltimore, MD 21218
Phone (410) 554-2651

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

600 N Wolfe St
Baltimore, MD 21287

6401 N Charles St
Rm 4226
Baltimore, MD 21212
Phone (443) 849-2121

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

17 Western Maryland Pkwy
Hagerstown, MD 21740
Phone (240) 420-0192

4924 Campbell Blvd
Ste 250
Nottingham, MD 21236
Phone (410) 321-1124

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

11210 Old Georgetown Rd
Rockville, MD 20852
Phone (301) 881-7770

46 W Gude Dr
Rockville, MD 20850
Phone (240) 750-6170

9000 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 682-7000

6701 N Charles St
Towson, MD 21204
Phone (443) 849-2000

6701 N Charles St
#4226
Towson, MD 21204
Phone (410) 296-4616

6701 N Charles St
Ste 4226
Towson, MD 21204
Phone (410) 296-4616

8322 Bellona Ave
Ste 201
Towson, MD 21204
Phone (410) 337-2688

Organizations & group practices 12

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": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1942490610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 WEST RD STE 210",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042341",
            "telephone_number": "410-296-4616",
            "fax_number": "410-337-5068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 N CHARLES ST",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212046808",
            "telephone_number": "410-296-4616",
            "fax_number": "410-337-5068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "LEE",
        "middle_name": "GORDON",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-30",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R144380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "R144380",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.