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Individual provider Active NPI

Jacquelyn Marie Carroll

  • Acute Care Nurse Practitioner
  • Greensburg, PA
National Provider Identifier
1972359263
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP028390 Issued in PA
Practice address
530 South St FL 2
Greensburg, PA 15601-2775
Phone
(724) 837-1894
Fax
(724) 837-0681
NPI assigned
Apr 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP028390 PA
Acute Care Nurse Practitioner 363LA2100X SP028390 PA Primary

Addresses

Primary practice location

530 South St FL 2
Greensburg, PA 15601-2775

Mailing address

530 South St FL 2
Greensburg, PA 15601-2775
Phone (724) 837-1894

Other names 1

  • Jacquelyn Marie Crowe Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jacquelyncarroll@emg.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240521004574 PA Practitioner - Nurse Practitioner 4688016744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

562 Shearer St
Suite 103
Greensburg, PA 15601-2746
Phone (724) 837-1894

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP028390PAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Excela Health Physician Practices, Inc. CurrentSince Jun 3, 2024 Accepting new patients
Excela Health Physician Practices, Inc. CurrentSince Jun 3, 2024 Accepting new patients
Excela Health Physician Practices, Inc Current Accepting new patients
Excela Health Physician Practices, Inc Past Accepting new patients

Locations

530 South St
Fl 2
Greensburg, PA 15601
Phone (724) 261-5556

530 South St
Ste G10
Greensburg, PA 15601
Phone (724) 689-1335

562 Shearer St
Ste 103
Greensburg, PA 15601
Phone (724) 850-3150

532 W Pittsburgh St
Greensburg, PA 15601
Phone (724) 832-4000

1 Mellon Way
Fl 3
Latrobe, PA 15650
Phone (724) 539-3870

1 Mellon Way
Latrobe, PA 15650
Phone (724) 537-1207

Organizations & group practices 4

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1714089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1972359263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 SOUTH ST FL 2",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156012775",
            "telephone_number": "724-837-1894",
            "fax_number": "724-837-0681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 SOUTH ST FL 2",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156012775",
            "telephone_number": "724-837-1894",
            "fax_number": "724-837-0681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JACQUELYN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-26",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP028390",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP028390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jacquelyncarroll@emg.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "EH Pulmonology Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "530 South St Fl 2",
            "city": "Greensburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "156012775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACQUELYN",
            "last_name": "CROWE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greensburg, PA

Sources for this page

Verify at the official NPI Registry.