PROF. BRIAN D. CARROLL (NPI# 1558789479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558789479 |
| Entity Type | Individual |
| Full Name | PROF. BRIAN D. CARROLL |
| Practice Address |
1909 W Coolidge Ave Marion IL 62959-1097 |
| Mailing Address |
1718 Winery Rd West Frankfort IL 62896-4907 |
| Practice Telephone | 6189975677 |
| Mailing Telephone | 6187270523 |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2014-03-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133V00000X | Dietitian, Registered | 2014006008 | MO | Dietary & Nutritional Service Providers |
| Y | 133V00000X | Dietitian, Registered | 164003714 | IL | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497369284 | Brian Carroll | Physician Assistant | 7242 Melotte St, San Diego, CA 92119-1613 | 2020-08-31 |
| 1982180378 | Brian Douglas Carroll | Registered Nurse | 4434 Ellipse Dr, Jacksonville, FL 32246-7450 | 2018-07-18 |
| 1447399175 | Brian R. Carroll | Dentist | 34405 Grand River Ave, Farmington, MI 48335-3309 | 2007-02-06 |
| 1023180999 | Brian C Carroll | Chiropractor | 1484 Broadway Ave, Holbrook, NY 11741 | 2006-11-15 |
| 1972066579 | Brian Gerard Carroll | Student in an Organized Health Care Education/Training Program | 110 Bergen St, Newark, NJ 07103-2495 | 2019-04-10 |
| 1417449810 | Brian Carroll | Registered Nurse | 800 W 5th Ave, Spokane, WA 99204-2803 | 2018-05-31 |
| 1659799351 | Brian Jeffrey Carroll | Pediatrics | 2530 Chicago Ave Ste 400, Minneapolis, MN 55404-4387 | 2014-03-31 |
| 1891113775 | Brian John Carroll | Obstetrics & Gynecology | 757 Park Ave W Ste 2800, Highland Park, IL 60035 | 2014-03-28 |
| 1790089613 | Brian Christopher Carroll | Speech-Language Pathologist | 2731 Sunberry Ln Nw, Concord, NC 28027-6555 | 2011-01-06 |
| 1447472527 | Brian R Carroll | Social Worker | 19 W 34th St, Penthouse Suite, New York, NY 10001-3006 | 2007-05-02 |
| Street Address |
1909 W COOLIDGE AVE |
| City | MARION |
| State | IL |
| Zip Code | 62959-1097 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558468975 | Cindy A Henley | Nurse Practitioner | 1909 W Coolidge Ave, Marion, IL 62959 | 2006-09-20 |
| 1972857613 | Docrx Inc | Family Medicine | 1909 W Coolidge Ave, Marion, IL 62959-1097 | 2012-11-02 |
| 1659632602 | Si Medical, Inc. | Dietitian, Registered | 1909 W Coolidge Ave, Marion, IL 62959-1097 | 2012-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710513486 | Sarah Benitone | Counselor | 11264 Il-37, Marion, IL 62959 | 2020-03-13 |
| 1528609328 | Patricia E Murphy | Radiology | 4503 1/2 W Deyoung, Suite 3a, Marion, IL 62959 | 2019-10-02 |
| 1366007007 | Centerstone of Illinois, Inc | Community/Behavioral Health | 202 S Bentley St, Marion, IL 62959 | 2019-05-08 |
| 1649752064 | Sydney Seiter | Occupational Therapist | 906 Skyline Suite 100, Marion, IL 62959 | 2018-09-01 |
| 1497279848 | Brooke Alisa Osman | Licensed Practical Nurse | 11531 Sunderland Road, Marion, IL 62959 | 2017-07-27 |
| 1912436429 | Joy L. Kee | Social Worker | 509 South Bentley Street, Marion, IL 62959 | 2017-06-08 |
| 1386181170 | Susan Smothers | Counselor | 1305 West Main Street, Marion, IL 62959 | 2017-01-31 |
| 1205280922 | Harish Kempegowda | Orthopaedic Surgery | 3331 W Deyoung St Ste 201, Marion, IL 62959 | 2016-04-19 |
| 1942609227 | Casey Hill | Social Worker | 1604 W. Walnut St., Marion, IL 62959 | 2014-08-22 |
| 1306252812 | Justin M White | Chiropractor | 1603 W Kimmel, Marion, IL 62959 | 2014-07-03 |
| Find all providers in zip 62959 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487173571 | Melissa Mclaughlin | Dietitian, Registered | 3600 Highway 151, Marion, IA 52302 | 2017-09-11 |
| 1659635548 | Jennifer Ann Heringhausen | Dietitian, Registered | 3600 Business Hwy 151 E, Marion, IA 52302 | 2012-06-26 |
| 1932411279 | Stephanie E. Skinner | Dietitian, Registered | 649 1/2 Goolsby St, Marion, VA 24354-1703 | 2010-07-01 |
| 1306067350 | Jeannine Marcum | Dietitian, Registered | 3058 Claridon Westfield Road, Marion, OH 43302-8968 | 2007-05-01 |
| 1932274263 | Susan Lee Morvich | Dietitian, Registered | 2401 W Main Street Rm 113 Nhcu, Veterans Administration Medical Center, Marion, IL 62959 | 2006-11-21 |
| 1407456593 | Ann Hett | Dietitian, Registered | 535 S Freeborn St, Marion, KS 66861-1256 | 2020-10-28 |
| 1669018594 | Marybeth Pecina | Dietitian, Registered | 1700 E 38th St, Marion, IN 46953-4568 | 2019-11-26 |
| 1003463019 | Robert Joseph Simmons | Dietitian, Registered | 441 N Wabash Ave, Marion, IN 46952-2690 | 2019-08-23 |
| 1912559352 | Tori Gusewelle | Dietitian, Registered | 2401 W Main St, Marion, IL 62959-1188 | 2019-07-16 |
| 1609331016 | Anna Lois Mccullough | Dietitian, Registered | 441 N Wabash Ave, Marion, IN 46952-2690 | 2019-02-10 |
| Find all providers in MARION | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.