COLONIAL CITY INTERNAL MEDICINE, INC. – Internal Medicine Physician, NPI 1396769980

COLONIAL CITY INTERNAL MEDICINE, INC. is a healthcare provider. based in Mount vernon, Ohio. specializing in Internal Medicine Physician. The organization holds a License No. 80624 (OH). The NPI Number for COLONIAL CITY INTERNAL MEDICINE, INC. is 1396769980

Main info

Organization
Name
COLONIAL CITY INTERNAL MEDICINE, INC.
NPI
1396769980
Phone
(740) 397-2915
Address
1661 VENTURE DR
Authorized Official
DR. FREDEROCL CHARLES CARROLL PRESIDENT M.D.
Enumeration Date
27 July 2006
Last Update Date
22 August 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for COLONIAL CITY INTERNAL MEDICINE, INC.

  • 1661, Venture Drive, Mount Vernon, Knox County, Ohio, 43050, United States

    SUITE A

    MOUNT VERNON, OH 430508928

    Phone: (740) 397-2915

    Fax: (740) 397-3870

    Type: Location

  • Mount Vernon Post Office, Broadway Street, Mount Vernon, Jefferson County, Illinois, 62864, United States

    MOUNT VERNON, OH 430508124

    Phone: (740) 397-2975

    Fax: (740) 397-3870

    Type: Mailing

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.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

No Medicare enrollment or revalidation data available for this provider in our database.

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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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 43050)

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Reviews

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Frequently asked questions

How is COLONIAL CITY INTERNAL MEDICINE, INC. identified in CMS data?
CMS-hosted NPPES data lists COLONIAL CITY INTERNAL MEDICINE, INC. with NPI 1396769980.
Is COLONIAL CITY INTERNAL MEDICINE, INC. still practicing?
COLONIAL CITY INTERNAL MEDICINE, INC. is currently listed as active in the public NPI registry.
What is COLONIAL CITY INTERNAL MEDICINE, INC.'s specialty?
The listing groups COLONIAL CITY INTERNAL MEDICINE, INC. with Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What address line appears for COLONIAL CITY INTERNAL MEDICINE, INC.?
COLONIAL CITY INTERNAL MEDICINE, INC.'s geographic hint is Mount Vernon, Ohio in our summary view.
Is the information about COLONIAL CITY INTERNAL MEDICINE, INC. up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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