Active NPI
Shamari Carroll, PT, DPT
- Physical Therapist
- MC Lean, VA
National Provider Identifier
1992442404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305214960
- Practice address
- 6733 Curran St Ste 100
MC Lean, VA 22101-6032 - Phone
- (703) 448-0259
- NPI assigned
- May 16, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305214960 | VA | Primary |
Addresses
Primary practice location
6733 Curran St Ste 100
MC Lean, VA 22101-6032
Mailing address
2216 Laguard Dr
Hampton, VA 23661-2416
Phone (757) 329-9764
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305214960 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652659200000",
"number": "1992442404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2216 LAGUARD DR",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236612416",
"telephone_number": "757-329-9764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6733 CURRAN ST STE 100",
"city": "MC LEAN",
"state": "VA",
"postal_code": "221016032",
"telephone_number": "703-448-0259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "SHAMARI",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-16",
"last_updated": "2022-05-16",
"certification_date": "2022-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305214960",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in MC Lean, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.