CHRISTOPHER SHANE CARROLL NP-C NPI 1205389335

NPI Information

NPI: 1205389335
Provider Name: CHRISTOPHER SHANE CARROLL, NP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
10706 MARLBORO AVE.
BARNWELL, SC
ZIP 29812
Phone: (803) 259-7337
Get Directions

Christopher Shane Carroll, NP-C is a family nurse practitioner in Barnwell, SC. Christopher Shane Carroll, NP-C NPI is 1205389335. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

10706 MARLBORO AVE.
BARNWELL, SC
ZIP 29812-516
Phone: (803) 259-7337

The NPI 1205389335 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/25/2016 and was last updated on 1/11/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	20366	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	20366	OTHER	SOUTH CAROLINA	MEDICAL LICENSE
2	NP4003	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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