BRYAN CARROLL (NPI# 1609087121) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1609087121 |
Entity Type | Individual |
Full Name | BRYAN CARROLL |
Credential | M.D. |
Practice Address |
721 Fairfax Ave Ste 200 Norfolk VA 23507-2007 |
Mailing Address |
11100 Euclid Ave Cleveland OH 44106-1716 |
Practice Telephone | 7574465629 |
Practice Fax Number | 7574466000 |
Mailing Telephone | 2168441000 |
Enumeration Date | 2007-05-25 |
Last Update Date | 2019-07-16 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207N00000X | Dermatology | 0101252291 | VA | Allopathic & Osteopathic Physicians |
Y | 207N00000X | Dermatology | 35.137019 | OH | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
VA | ANTHEM BC/BS | 473606 | 01 |
VA | CORVEL | PAR | 01 |
VA | AETNA | PAR | 01 |
VA | TRICARE/CHAMPUS | -005 | 01 |
NC | 5921028 | 05 | |
VA | COVENTRY HEALTH NETWORK | 1609087121 | 01 |
VA | MULTIPLAN | PAR | 01 |
VA | UNITED HEALTHCARE | 1609087121 | 01 |
VA | 1609087121 | 05 | |
VA | USA MANAGED CARE | PAR | 01 |
VA | OPTIMA HEALTH | 10097097 | 01 |
VA | CIGNA | PAR | 01 |
VA | VIRGINIA PREMIER HEALTH PLAN | 1609087121 | 01 |
VA | VIRGINIA HEALTH NETWORK | PAR | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134486582 | Bryan J Carroll | Dermatology | 901 7th Ave, Fort Worth, TX 76104-2722 | 2012-04-23 |
Street Address |
721 FAIRFAX AVE STE 200 |
City | NORFOLK |
State | VA |
Zip Code | 23507-2007 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245237791 | Beverly Lavern Roberts-atwater | Physical Medicine & Rehabilitation | 721 Fairfax Ave, 3rd Floor, Norfolk, VA 23507-2007 | 2005-06-30 |
1477161610 | Alyssa Joyce Jessup | Nurse Practitioner | 721 Fairfax Ave, Norfolk, VA 23507-2007 | 2020-07-14 |
1285253500 | Emily Ruth Cunningham | Student in an Organized Health Care Education/Training Program | 721 Fairfax Ave, Norfolk, VA 23507-2007 | 2020-04-16 |
1043872005 | Zahra Tasneem | Student in an Organized Health Care Education/Training Program | 721 Fairfax Ave, Norfolk, VA 23507-2007 | 2019-06-30 |
1508427741 | Reema Husni Abughoush | Student in an Organized Health Care Education/Training Program | 721 Fairfax Ave, Norfolk, VA 23507-2007 | 2019-06-27 |
1891350443 | Stephan Duran | Student in an Organized Health Care Education/Training Program | 721 Fairfax Ave, Norfolk, VA 23507-2007 | 2019-05-08 |
1396208500 | Kelly Starosta Hill | Student in an Organized Health Care Education/Training Program | 721 Fairfax Ave, Norfolk, VA 23507-2007 | 2019-04-14 |
1205396884 | Zeeshan Toor | Student in an Organized Health Care Education/Training Program | 721 Fairfax Ave, Norfolk, VA 23507-2007 | 2019-03-21 |
1861952434 | Steve Mark D'souza | Student in an Organized Health Care Education/Training Program | 721 Fairfax Ave, Norfolk, VA 23507-2007 | 2019-03-20 |
1932668738 | Abigail Winz | Student in an Organized Health Care Education/Training Program | 721 Fairfax Ave, Norfolk, VA 23507-2007 | 2019-03-19 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790306801 | Paolo Quentin Rigo | Student in an Organized Health Care Education/Training Program | Smith Rogers Hall, 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-04-29 |
1811526221 | Sean M Whitty | Student in an Organized Health Care Education/Training Program | Emergency Medicine Residency, Raleigh Building, St 304, 600 Gresham Dr, Norfolk, VA 23507 | 2020-04-07 |
1962030643 | Shekinah Joy Vaughn | Student in an Organized Health Care Education/Training Program | 385 Mowbray Arch Ste 203205, Norfolk, VA 23507 | 2020-03-30 |
1982231403 | Jaxon Vallely | Student in an Organized Health Care Education/Training Program | 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-03-25 |
1437714656 | Kanishk Deep Sharma | Student in an Organized Health Care Education/Training Program | 825 Fairfax Avenue Eastern Virginia Medical School Inte, Suite 445, Norfolk, VA 23507 | 2019-05-02 |
1619439460 | Dylan Woolum | Student in an Organized Health Care Education/Training Program | Raleigh Building, Suite 304, 600 Gresham Drive, Norfolk, VA 23507 | 2019-04-02 |
1477012623 | Jessie R Jones | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 513a, Norfolk, VA 23507 | 2019-03-18 |
1316416787 | Lindsey Sawyer | Genetic Counselor, MS | Childrens Hospital of The Kings Daughters, 601 Childrens Lane, Norfolk, VA 23507 | 2018-11-15 |
1881188159 | Patrick Michael Haar | Pharmacist | 601 Pembroke Avenue, Apt 104, Norfolk, VA 23507 | 2018-06-19 |
1316438377 | Monika Pajhal | Student in an Organized Health Care Education/Training Program | Eastern Virginia Medical School (internal Medicine), Internal Medicine, 825 Fairfax Ave, Suite 410, Norfolk, VA 23507 | 2018-05-25 |
Find all providers in zip 23507 |
Taxonomy Code | 207N00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932582467 | Anh Khoa Pham | Dermatology | 850 Kempsville Rd Ste 100d, Norfolk, VA 23502-3920 | 2015-07-01 |
1801238472 | Integrated Dermatology of Tidewater LLC | Dermatology | 885 Kempsville Rd Ste 309, Norfolk, VA 23502-3800 | 2013-07-24 |
1144575473 | Kmn Dermatology & Aesthetics PC | Dermatology | 146 Main St, Ste 2b, Norfolk, MA 02056-1322 | 2012-07-24 |
1326363292 | Bruce Daniel Bauer | Dermatology | 6160 Kempsville Cir Ste 200a, Norfolk, VA 23502-3945 | 2010-04-02 |
1164495115 | Brian L Johnson | Dermatology | 5630 Lowery Rd, Norfolk, VA 23502-2233 | 2006-02-09 |
1003887118 | Evms Academic Physicians and Surgeons Health Services Foundation | Dermatology | 4111 Monarch Way, Suite 500, Norfolk, VA 23508-2559 | 2006-01-27 |
1184076796 | Robert James Smith | Dermatology | 721 Fairfax Ave Ste 200, Norfolk, VA 23507-2007 | 2016-07-07 |
1912351032 | Andrew Raul Villanueva | Dermatology | 721 Fairfax Ave Ste 200, Norfolk, VA 23507-2007 | 2016-04-14 |
1760845986 | Adelaida Gyurjyan-bunch | Dermatology | 6160 Kempsville Cir Ste 200a, Norfolk, VA 23502-3945 | 2016-04-04 |
1780932129 | Natalia Mendoza | Dermatology | 6160 Kempsville Cir Ste 200a, Norfolk, VA 23502-3945 | 2012-08-15 |
Find all providers in NORFOLK |
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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.