KATHLEEN ELIZABETH CARROLL (MSN, FNP-C) – Family Nurse Practitioner, NPI 1104367283

KATHLEEN ELIZABETH CARROLL (MSN, FNP-C) is a healthcare provider. based in Jackson, Tennessee. specializing in NURSE PRACTITIONER. They hold the professional credentials MSN, FNP-C. They hold a License No. APN0000022418 (TN). The NPI Number for KATHLEEN ELIZABETH CARROLL (MSN, FNP-C) is 1104367283

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
KATHLEEN ELIZABETH CARROLL (MSN, FNP-C)
NPI
1104367283
Phone
Not provided
Address
17 CENTRE PLAZA DR
Enumeration Date
9 March 2017
Last Update Date
9 March 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7314244200
Graduation Year
2016 (10 years ago)
PAC ID
9830474949
Group Practice PAC ID
2163653478
Professional Enrollment ID
I20170331001054
Address ID
TN383014366JA45XXXCVXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

10,656 NURSE PRACTITIONER in TN

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Provider Addresses for KATHLEEN ELIZABETH CARROLL (MSN, FNP-C)

  • 17, Plaza Drive, Ravenswood, Jackson County, West Virginia, 26164, United States

    JACKSON, TN 383052862

    Phone:

    Mailing address matches the actual address.

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: 2017-03-31

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
I20170331001054INurse PractitionerTNTBD

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
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes485117$0
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes14674$0
90792Psychiatric diagnostic evaluation with medical services6262$0
90791Psychiatric diagnostic evaluation2222$0
View full utilization report →

Insurance plans in this area (ZIP 38305)

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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: 2163653478View full group profile
NameSpecialtyState
Nurse PractitionerTN
-TN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerTN
Nurse PractitionerMS
Nurse PractitionerMS
Nurse PractitionerIL
Nurse PractitionerTN
Nurse PractitionerMS

Reviews

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Frequently asked questions

What federal number belongs to KATHLEEN ELIZABETH CARROLL (MSN, FNP-C)?
The federal identifier for KATHLEEN ELIZABETH CARROLL (MSN, FNP-C) is NPI 1104367283.
Is KATHLEEN ELIZABETH CARROLL (MSN, FNP-C) active in the national directory?
KATHLEEN ELIZABETH CARROLL (MSN, FNP-C)'s public NPI profile is in an active state.
What does KATHLEEN ELIZABETH CARROLL (MSN, FNP-C) treat or focus on?
Patients typically see KATHLEEN ELIZABETH CARROLL (MSN, FNP-C) under the specialty Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is KATHLEEN ELIZABETH CARROLL (MSN, FNP-C)'s primary listing?
We display Jackson, Tennessee because that is what the record indicates for KATHLEEN ELIZABETH CARROLL (MSN, FNP-C).
How can I contact KATHLEEN ELIZABETH CARROLL (MSN, FNP-C)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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