Active NPI
Kimberly Jeanne Carroll, M.D.
- Rheumatology Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 2015027133
- Practice address
- 3023 N Ballas Rd Ste 500
Saint Louis, MO 63131-2359 - Phone
- (314) 996-7930
- Fax
- (314) 996-7935
- NPI assigned
- Apr 19, 2009
- Last updated
- Feb 12, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 56232 | WI | |
| Rheumatology Physician | 207RR0500X | 2015027133 | MO | Primary |
Addresses
Primary practice location
3023 N Ballas Rd Ste 500
Saint Louis, MO 63131-2359
Mailing address
670 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141-8573
Phone (314) 996-7930
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982847042 | Medicaid | WI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Rheumatology
- Education
- Medical College of Wisconsin, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195
2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454
3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5772
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015027133 | MO | MD | Rheumatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Groups LC | Internal Medicine | Current | Accepting new patients |
| Physician Groups LC | Current | Accepting new patients |
Locations
2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454
3023 N Ballas Rd
Ste 500
Saint Louis, MO 63131
Phone (314) 567-4541
3023 N Ballas Rd
Ste 500D
Saint Louis, MO 63131
Phone (314) 567-4541
670 Mason Ridge Center Dr
Ste 300
Saint Louis, MO 63141
Phone (314) 996-7644
201 Bjc Saint Peters Dr
Ste 200
Saint Peters, MO 63376
Phone (636) 916-7060
Interoperability endpoints
- kcarroll11308@direct.carenet.org
Organizations & group practices 2
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.
-
dba Medical Arts Clinic
- Multi-Specialty Clinic/Center
- Farmington, MO
- NPI 1427114990
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1649299827
-
dba Barnes-Jewish St Peters Hospital
- General Acute Care Hospital
- Saint Peters, MO
- NPI 1144238908
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1831107895
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1487663506
-
dba Memorial Hospital
- General Acute Care Hospital
- Belleville, IL
- NPI 1982796181
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613088000000",
"number": "1982847042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "670 MASON RIDGE CENTER DR",
"address_2": "STE 300",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418573",
"telephone_number": "314-996-7930",
"fax_number": "314-996-7935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3023 N BALLAS RD STE 500",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631312359",
"telephone_number": "314-996-7930",
"fax_number": "314-996-7935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "KIMBERLY",
"middle_name": "JEANNE",
"name_prefix": "Ms.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-19",
"last_updated": "2021-02-12",
"certification_date": "2021-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "56232",
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "MO",
"license": "2015027133",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1982847042",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "BJC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3023 N Ballas Rd Ste 500",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631312359",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.