Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Douglas John Carroll, PA-C

Individual provider Medical Physician Assistant · NPI 1649428277

Mr. Douglas John Carroll, PA-C is a Physician Assistant in Johnson City, Tennessee. Qualified in 2008, 18 years ago. Practices with Blue Ridge Medical Management Corporation, a 286-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in North Carolina and Tennessee.

Years since qualifying
18
Licensed in
NC, TN
In the registry since
2008
Specialties on file
4
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

2410 Susannah St
Johnson City, TN 37601-1748
Phone: (423) 282-9011
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 340 Steeles Rd, Bristol, TN 37620 — (423) 282-9011
  • 800 S Mohawk Dr Ste C, Erwin, TN 37650-2124 — (423) 735-4750
  • 875 Larry Neil Way, Kingsport, TN 37660-6368 — (423) 282-9570

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 3434 (TN)
Physician Assistant Taxonomy 363A00000X · Licence 0010-01521 (NC)
Physician Assistant Taxonomy 363A00000X · Licence 3434 (TN)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 3434 (TN)

Record details

NPI number1649428277
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedSeptember 8, 2008
Last updated in NPPESSeptember 30, 2025
Certification dateSeptember 30, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Blue Ridge Medical Management Corporation — 286 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Johnson City