KATHLEEN KELLY CARROLL M.S., M.A., APRN-BC
NPI 1376674010
Nurse Practitioner - Psychiatric/Mental Health in Fayetteville, NC
About Kathleen Kelly Carroll M.s., M.a., Aprn-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KATHLEEN KELLY CARROLL M.S., M.A., APRN-BC (NPI 1376674010) is an individual psychiatric/mental health provider in Fayetteville, North Carolina, licensed in North Carolina (200401185) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS and is a graduate of University Of South Alabama College Of Medicine (2006).
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kathleen Kelly Carroll M.s., M.a., Aprn-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Kathleen Carroll reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Albuquerque, NM 87109
- Reassigned Medicare billing, New Mexico enrollment
- 3 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 28305 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kathleen Carroll's NPI number?
The NPI number for Kathleen Carroll is 1376674010. It was assigned to this individual provider in the NPPES registry on March 7, 2007.
Where is Kathleen Carroll located?
Kathleen Carroll practices at 805 Westmont Dr, Fayetteville, NC 28305. The listed phone number is (910) 484-4061.
What is Kathleen Carroll's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Kathleen Carroll enrolled in Medicare?
Yes. Kathleen Carroll is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kathleen Carroll's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kathleen Carroll reassigns Medicare benefits to Christian Counseling Professionals, Inc. (Albuquerque, NM). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kathleen Carroll's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kathleen Carroll was last updated on May 22, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kathleen Kelly Carroll, M.S., M.A., APRN-BC · NPI 1376674010
Psychiatric/Mental Health physician in Fayetteville, North Carolina. Individual provider, active in the CMS NPPES registry since March 7, 2007.
## Identity
- **NPI:** 1376674010 (Entity type: Individual)
- **Enumerated:** March 7, 2007
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 200401185 (North Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 805 WESTMONT DR, Fayetteville, NC 28305-4555
- **Phone:** (910) 484-4061 · **Fax:** (910) 485-4069
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Christian Counseling Professionals, Inc. (NPI 1598090763, Albuquerque, NM), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of South Alabama College Of Medicine, class of 2006
## Record status
- **NPPES last updated:** May 22, 2008
- **Other identifiers:** Medicaid 6113055 (NC)
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Source: [NPI Profile](https://npiprofile.com/npi/1376674010) · Data from the CMS NPPES public registry.