CLAYTON O CARROLL (PT, DPT, SCS) – Physical Therapist, NPI 1114404589

CLAYTON O CARROLL (PT, DPT, SCS) is a healthcare provider. based in Bolingbrook, Illinois. specializing in Physical Therapist. They hold the professional credentials PT, DPT, SCS. They hold a License No. PT013679 (GA). The NPI Number for CLAYTON O CARROLL (PT, DPT, SCS) is 1114404589

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
CLAYTON O CARROLL (PT, DPT, SCS)
NPI
1114404589
Phone
Not provided
Address
790 REMINGTON BLVD
Enumeration Date
27 July 2018
Last Update Date
10 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7065491663
Graduation Year
2018 (8 years ago)
PAC ID
2961748942
Group Practice PAC ID
5991600181
Professional Enrollment ID
I20190111001915
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:7State licenses:1Digital endpointsOther names

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Provider Addresses for CLAYTON O CARROLL (PT, DPT, SCS)

  • 790 REMINGTON BLVD

    BOLINGBROOK, IL 604404909

    Phone:

    Type: Mailing

  • 1765 OLD WEST BROAD ST BLDG 2-200

    ATHENS, GA 306062887

    Phone: (706) 549-1663

    Fax: (706) 546-8792

    Type: Mailing

  • Old West Broad Street, Athens, Athens-Clarke County, Georgia, 30606, United States

    ATHENS, GA 306062853

    Phone: (706) 549-1663

    Fax: (706) 546-8792

    Type: Location

  • 6422 BELLS FERRY RD UNIT B124

    WOODSTOCK, GA 301896114

    Phone: (770) 372-1211

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-01-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190111001915IPhysical Therapist In Private PracticeGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97530Therapy procedure using functional activities70440$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes34736$0
97140Therapy procedure using manual technique, each 15 minutes10919$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes9816$0
97161Evaluation for physical therapy, typically 20 minutes1715$0
View full utilization report →

Insurance plans in this area (ZIP 60440)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991600181View full group profile
NameSpecialtyState
-GA
Occupational Therapist In Private PracticeGA
-GA
Physician AssistantGA
Physical Therapist In Private PracticeGA
Occupational Therapist In Private PracticeGA
Orthopedic SurgeryGA
Orthopedic SurgeryGA
-GA
-GA

Reviews

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Frequently asked questions

Is there an official ID for CLAYTON O CARROLL (PT, DPT, SCS) in U.S. healthcare records?
The official identifier for CLAYTON O CARROLL (PT, DPT, SCS) is NPI 1114404589.
Active or inactive — what applies to CLAYTON O CARROLL (PT, DPT, SCS)?
You should see CLAYTON O CARROLL (PT, DPT, SCS) as active in CMS-hosted NPPES data.
How would a patient describe CLAYTON O CARROLL (PT, DPT, SCS)'s focus?
For CLAYTON O CARROLL (PT, DPT, SCS), the primary taxonomy reads as Physical Therapist. Clinical services aligned with this taxonomy classification.
Where in Illinois is CLAYTON O CARROLL (PT, DPT, SCS) registered?
Use Bolingbrook, Illinois as the headline location for CLAYTON O CARROLL (PT, DPT, SCS) here.
What does 5 location(s) imply?
5 practice locations appear in the available data.

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