MR. JOHN L CARROLL (NPI# 1679689616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679689616 |
| Entity Type | Individual |
| Full Name | MR. JOHN L CARROLL |
| Credential | PA-C |
| Practice Address |
1800 East Park Ave State College PA 16803 |
| Mailing Address |
514 Bellefonte Ave Lock Haven PA 17745 |
| Practice Telephone | 8142317850 |
| Mailing Telephone | 5707486632 |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2016-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | MA052618 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043853658 | John Carroll | Marriage & Family Therapist | 400 W 23rd St Apt 5j, New York, NY 10011-2176 | 2019-10-26 |
| 1376852301 | John Carroll | Emergency Medicine | 2727 W Heading Ave, West Peoria, IL 61604-4981 | 2010-09-24 |
| 1417151440 | John Raymond Carroll | Student in an Organized Health Care Education/Training Program | 42 E. Laurel Rd, Udp At Umdnj-som, Dept. of Family Medicine, Rm 2100, Stratford, NJ 08084 | 2007-06-13 |
| 1396869210 | John Francis Carroll | Pediatrics | 108 Canal Walk Blvd, Somerset, NJ 08873-7277 | 2007-03-17 |
| 1508946054 | John T Carroll | Podiatrist | 455 Boston Post Rd Ste 8, Old Saybrook, CT 06475-1554 | 2006-10-17 |
| 1457379042 | John Thomas Carroll | Obstetrics & Gynecology | 503 Thornhill Dr, Carol Stream, IL 60188-2780 | 2006-07-18 |
| 1952340069 | John L Carroll | Dentist | 1020 5th St Se, Winter Haven, FL 33880-4210 | 2006-06-05 |
| 1063468932 | John Anthony Carroll | Internal Medicine | 8328 E Hartford Dr, Scottsdale, AZ 85255-6520 | 2006-05-25 |
| 1508811860 | John D Carroll | Internal Medicine | 10689 Hardin Valley Rd, Knoxville, TN 37932-1504 | 2006-05-24 |
| 1376511717 | John M Carroll | Internal Medicine | 390 Pleasant St, Malden, MA 02148-8114 | 2006-03-10 |
| Street Address |
1800 EAST PARK AVE |
| City | STATE COLLEGE |
| State | PA |
| Zip Code | 16803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659340818 | James V Lieb | Internal Medicine | 1800 East Park Ave, Lance and Ellen Shaner Cancer Pavilion, State College, PA 16803-6797 | 2006-03-17 |
| 1871911610 | Kyle Lewis | Emergency Medicine | 1800 East Park Ave, State College, PA 16803-1501 | 2014-03-30 |
| 1730409145 | Theresa Lunsford | Nurse Anesthetist, Certified Registered | 1800 East Park Ave, State College, PA 16803-2020 | 2010-06-08 |
| 1609891365 | Centre Emergency Medical Associates, PC. | Emergency Medicine | 1800 East Park Ave, State College, PA 16803-6701 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851581 | Tammy Lynn Terosky | Massage Therapist | 2134 Sandy Drive, Suite 6, State College, PA 16803 | 2020-08-12 |
| 1548748973 | Molly Gomez | Occupational Therapist | 260 Lions Hill Road, State College, PA 16803 | 2018-07-28 |
| 1568981827 | David Scott Kautz | Pharmacist | 1665 North Atherton Place, State College, PA 16803 | 2017-09-18 |
| 1245751023 | Zenovia Tarmohamed | Student in an Organized Health Care Education/Training Program | 1850 East Park Avenue, Suite 207, Penn State Health At Mount Nittany Medical Center, State College, PA 16803 | 2017-06-30 |
| 1407205362 | Alka Sood | Student in an Organized Health Care Education/Training Program | 1850 E. Park Avenue, State College, PA 16803 | 2016-06-10 |
| 1588018766 | Daniel Frankel | Student in an Organized Health Care Education/Training Program | 1850 East Park Avenue, Suite 207, State College, PA 16803 | 2016-04-14 |
| 1154791903 | Megan Widener | Physician Assistant | 2520 Green Tech Dr., Ste. D, State College, PA 16803 | 2015-10-05 |
| 1114301330 | Phuong Tran Courtney | Physician Assistant | 1613 North Atherton Street, Suite B, State College, PA 16803 | 2015-07-17 |
| 1164806840 | Amit Thatte | Student in an Organized Health Care Education/Training Program | 1850 East Park Ave., Suite 207, Penn State Hershey Medical Group, State College, PA 16803 | 2015-07-13 |
| 1245588946 | Phoenix Rehabilitation and Health Services, Inc. | Chiropractor | 1700 Old Gatesburg Road, Suite 210, State College, PA 16803 | 2012-08-28 |
| Find all providers in zip 16803 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154791903 | Megan Widener | Physician Assistant | 2520 Green Tech Dr., Ste. D, State College, PA 16803 | 2015-10-05 |
| 1114301330 | Phuong Tran Courtney | Physician Assistant | 1613 North Atherton Street, Suite B, State College, PA 16803 | 2015-07-17 |
| 1740685858 | Mallory L. Miller | Physician Assistant | 100 Radnor Rd Ste 101, State College, PA 16801 | 2014-10-31 |
| 1114100344 | Kimberly Johnson | Physician Assistant | 1850 E Park Ave Ste 103, Cema, Er, State College, PA 16803-6706 | 2007-12-11 |
| 1184778045 | Krista L. Sharer | Physician Assistant | 1630 North Atherton St., State College, PA 17822-5622 | 2007-01-22 |
| 1427077197 | Nathaniel L. Pozniak | Physician Assistant | 1700 Old Gatesburg Rd Ste 200, State College, PA 16803-2276 | 2006-07-19 |
| 1548212970 | Geisinger Clinic | Physician Assistant | 2520 Green Tech Drive, Ste D, State College, PA 16803 | 2006-05-16 |
| 1528019056 | Geisinger Clinic | Physician Assistant | 200 Scenery Drive, State College, PA 16801 | 2006-05-12 |
| 1205824075 | Victoria D Case | Physician Assistant | 2121 Old Gatesburg Rd, Suite 100, State College, PA 16803-2290 | 2005-10-06 |
| 1194725812 | Scott E Butler | Physician Assistant | 1700 Old Gatesburg Rd, Ste 100, State College, PA 16803-2276 | 2005-07-22 |
| Find all providers in STATE COLLEGE | ||||
| City | STATE COLLEGE |
| Zip Code | 16803 |
Please comment or provide details below to improve the information on MR. JOHN L CARROLL.
| 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.