BRENDA ANN CARROLL, M.D. — NPI 1396739595 (Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine, Occupational Medicine in LUGOFF, SC)

CMS-1500 Box 24J / 33a • NPI

1396739595

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

2083X0100X (CMS 84)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine, Occupational Medicine

Box 32 Service Location & ZIP+4

643 HIGHWAY 1 S, LUGOFF, SC, 29078-9174

✓ 9-Digit EDI 837 ZIP+4 (29078-9174)

Practice Phone & Referral Fax

(928) 750-2891

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1396739595 (BRENDA ANN CARROLL, M.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1396739595` (NPI-1 Individual Practitioner)
Provider / Legal Name	BRENDA ANN CARROLL, M.D.
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine, Occupational Medicine NUCC Code: `2083X0100X` (Preventive Medicine, Occupational Medicine)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	643 HIGHWAY 1 S, LUGOFF, SC, 29078-9174
Practice Telephone / Fax	Tel: (928) 750-2891
Administrative Mailing Address	1723 LAKEVIEW AVE, CAMDEN, SC, 29020-2728
Enumeration & Last Sync	Enumerated: 2005-09-02 \| CMS Record Updated: 2024-07-12

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

643 HIGHWAY 1 S, LUGOFF, SC, 29078-9174

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Plain-English Taxonomy & CMS Crosswalk (2083X0100X)

What Does Taxonomy Code 2083X0100X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2083X0100X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine, Occupational Medicine"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 84 (Physician/Preventive Medicine)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Preventive Medicine, Occupational Medicine for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (BRENDA ANN CARROLL, M.D.)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`174400000X` — Specialist Plain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)	State: GA \| License: `053433` \| Primary: Secondary
`207RH0003X` — Internal Medicine, Hematology & Oncology Plain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)	State: AZ \| License: `41749` \| Primary: Secondary
`2083X0100X` — Preventive Medicine, Occupational Medicine Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine, Occupational Medicine	State: SC \| License: `15060` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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BRENDA ANN CARROLL, M.D. (NPI #1396739595)