Individual provider Active NPI

Thomas Richard McCarroll, D.C.

  • Chiropractor
  • Danbury, CT
National Provider Identifier
1992845440
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
503 Issued in CT
Practice address
15 South St
Danbury, CT 06810-8147
Phone
(203) 794-1049
Fax
(203) 730-9721
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 503 CT Primary

Addresses

Primary practice location

15 South St
Danbury, CT 06810-8147

Mailing address

15 South St
Danbury, CT 06810-8147
Phone (203) 794-1049

Other identifiers 1

IdentifierTypeStateIssuer
004089349MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120510000008 CT Practitioner - Chiropractic 3274795448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Street Chiropractic CenterGroup PAC ID 4284883885, 2 clinicians

Practice addresses (Care Compare)

15 S St
Danbury, CT 06810-8147
Phone (203) 794-1049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
503CTMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
South Street Chiropractic Center Chiropractor CurrentSince Aug 7, 2012 Accepting new patients

Locations

15 South St
Danbury, CT 06810
Phone (203) 794-1049

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992845440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SOUTH ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068108147",
            "telephone_number": "203-794-1049",
            "fax_number": "203-730-9721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SOUTH ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068108147",
            "telephone_number": "203-794-1049",
            "fax_number": "203-730-9721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARROLL",
        "first_name": "THOMAS",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004089349",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.