Individual provider Active NPI

Mackenzie Carroll, DO

  • Family Medicine Physician
  • Middlesboro, KY
National Provider Identifier
1982333704
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
06091 Issued in KY
Practice address
1530 US Highway 25 E
Middlesboro, KY 40965-1861
Phone
(606) 654-9450
Fax
(606) 302-4240
NPI assigned
Jun 7, 2022
Last updated
Jul 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 06091 KY Primary

Addresses

Primary practice location

1530 US Highway 25 E
Middlesboro, KY 40965-1861

Mailing address

PO Box 40
Whitesburg, KY 41858-0040
Phone (606) 633-4823

Other practice location 1

4320 Holmestown Rd
Myrtle Beach, SC 29588-7837
Phone (843) 652-8440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250731000529 KY Practitioner - Family Practice 0749661379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lincoln Memorial University Medical Department, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1530 US Hwy 25 E
Middlesboro, KY 40965-1861
Phone (606) 654-9450

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
06091KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Comprehensive Health Corporation Current Accepting new patients
Mountain Comprehensive Health Corporation CurrentSince Jul 15, 2025 Accepting new patients
Mountain Comprehensive Health Corporation Family Medicine Current Accepting new patients
Mountain Comprehensive Health Corporation Family Medicine CurrentSince Jul 15, 2025 Accepting new patients

Locations

1530 US Highway 25 E
Middlesboro, KY 40965
Phone (606) 654-9450

226 Medical Plaza Ln
Whitesburg, KY 41858
Phone (606) 633-4871

Interoperability endpoints

  • Direct secure messaging: mackenzie.carrolldo.p1@direct.mtncomp.nextgenshare.com
  • Direct secure messaging: mcarroll04@arh.medalliesdirect.net
  • Direct secure messaging: mcarroll400033@direct.musc.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1982333704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "WHITESBURG",
            "state": "KY",
            "postal_code": "418580040",
            "telephone_number": "606-633-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 US HIGHWAY 25 E",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409651861",
            "telephone_number": "606-654-9450",
            "fax_number": "606-302-4240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4320 Holmestown Rd",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295887837",
            "country_code": "US",
            "telephone_number": "843-652-8440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MACKENZIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "06091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlesboro, KY

Sources for this page

Verify at the official NPI Registry.