KELLY ANNE CARROLL FNP
NPI 1912728023
Nurse Practitioner - Family in Southfield, MI

Q: What is Kelly Carroll's NPI number?

The NPI number for Kelly Carroll is 1912728023. It was assigned to this individual provider in the NPPES registry on October 21, 2024.

Q: What is Kelly Carroll's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Carroll was last updated on October 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.

Active since October 21, 2024PECOS Enrolled

17330 NORTHLAND PARK CT, SOUTHFIELD, MI 48075(248) 552-9500 Get Directions Write a Review

NPPES record last updated: October 21, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Kelly Anne Carroll Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY ANNE CARROLL FNP (NPI 1912728023) is an individual family provider in Southfield, Michigan, licensed in Michigan (4704305869) and active in the NPI registry since October 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1912728023

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKELLY ANNE CARROLLCredential: FNP

Location Address17330 NORTHLAND PARK CTSouthfield, MI 48075-4318

Mailing Address2135 Stonington LnRochester Hills, MI 48306-3164 · (248) 550-6646

Phone(248) 552-9500

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateOctober 21, 2024

NPPES CertifiedOctober 21, 2024

✔ NPI 1912728023 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MI · 4704305869

17330 NORTHLAND PARK CT, Southfield, MI 48075

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Anne Carroll Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2567978109

PECOS Enrollment IDI20250722000150

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48075 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PRIME HEALTH SERVICES LLC

Clinic/Center (Physical Therapy)

17330 NORTHLAND PARK CT
SOUTHFIELD, MI 48075

Oakland County (713) 391-7000

D.O.C DOCTORS ON CALL, PC

Clinic/Center (Health Service)

17330 NORTHLAND PARK CT, STE 100
SOUTHFIELD, MI 48075

Oakland County (248) 971-4880

NPH CONSULTANTS LLC

Nurse Practitioner (Primary Care)

17330 NORTHLAND PARK CT
SOUTHFIELD, MI 48075

Oakland County (124) 894-3453

FRANCINE ELLISON NP

Nurse Practitioner

17330 NORTHLAND PARK CT
SOUTHFIELD, MI 48075

Oakland County (248) 552-9500

MR. JAMES E. REED MSW

Social Worker (Clinical)

17330 NORTHLAND PARK CT
SOUTHFIELD, MI 48075

Oakland County (248) 552-7528

THERAPEUTIC REHAB PLLC

Physical Medicine & Rehabilitation

17330 NORTHLAND PARK CT, 201
SOUTHFIELD, MI 48075

Oakland County (248) 809-2853

SERENITY AVE. INTEGRATIVE SERVICES LLC

Clinic/Center (Multi-Specialty)

17330 NORTHLAND PARK CT
SOUTHFIELD, MI 48075

Oakland County (248) 422-1333

DUO HEALTH SERVICES LLC

Clinical Nurse Specialist (Gerontology)

17330 NORTHLAND PARK CT, SUITE 100
SOUTHFIELD, MI 48075

Oakland County (248) 798-3969

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 Kelly Carroll's NPI number?

The NPI number for Kelly Carroll is 1912728023. It was assigned to this individual provider in the NPPES registry on October 21, 2024.

Where is Kelly Carroll located?

Kelly Carroll practices at 17330 Northland Park Ct, Southfield, MI 48075. The listed phone number is (248) 552-9500.

What is Kelly Carroll's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kelly Carroll enrolled in Medicare?

Yes. Kelly Carroll is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kelly Carroll was last updated on October 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.