NPIMap

Individual provider Active NPI

Frederick Charles Carroll, M.D.

  • Internal Medicine Physician
  • Mount Vernon, OH
National Provider Identifier
1962431957
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.080624 Issued in OH
Practice address
1330 Coshocton Ave
Mount Vernon, OH 43050-1440
Phone
(740) 393-9000
Fax
(740) 392-0167
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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 80624 OH
Internal Medicine Physician 207R00000X 35.080624 OH Primary

Addresses

Primary practice location

1330 Coshocton Ave
Mount Vernon, OH 43050-1440

Mailing address

1330 Coshocton Ave
Mount Vernon, OH 43050-1440
Phone (740) 393-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040309000474 OH Practitioner - Internal Medicine 8820986086 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80624OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Knox Community Hospital CurrentSince Jun 2, 2014 Accepting new patients
Knox Community Hospital CurrentSince Jun 2, 2014 Accepting new patients
Knox Community Hospital Current Accepting new patients

Locations

1661 Venture Dr
Ste A
Mount Vernon, OH 43050
Phone (740) 397-2915

1330 Coshocton Ave
Fl 5
Mount Vernon, OH 43050
Phone (740) 393-9040

1451 Yauger Rd
Ste 1F
Mount Vernon, OH 43050
Phone (740) 397-8500

1330 Coshocton Ave
Mount Vernon, OH 43050
Phone (740) 393-9019

Interoperability endpoints

  • Direct secure messaging: frederickcarroll@kch.allscriptsdirect.net
  • FHIR API: https://app.meldrx.com/api/fhir/gemms-kno01

Organizations & group practices 11

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio State University College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knox Community Hospital 117 clinicians

Practice addresses (Care Compare)

1330 Coshocton Ave
Mount Vernon, OH 43050-1440

307 Vernedale Dr
Mount Vernon, OH 43050-2921

Hospital & facility affiliations

  • Knox Community Hospital Hospital, Mount Vernon, OH, CCN 360040

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1962431957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 COSHOCTON AVE",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430501440",
            "telephone_number": "740-393-9000",
            "fax_number": "740-392-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 COSHOCTON AVE",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430501440",
            "telephone_number": "740-393-9000",
            "fax_number": "740-392-0167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "FREDERICK",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "80624",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.080624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, OH

Sources for this page

Verify at the official NPI Registry.