Individual provider Active NPI

Macy Ann Carroll, OTD, OTR

  • Occupational Therapist
  • Tulsa, OK
National Provider Identifier
1053177063
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
3223 E 31St St
Tulsa, OK 74105-2452
Phone
(918) 250-7093
NPI assigned
Feb 27, 2024
Last updated
Feb 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU Primary

Addresses

Primary practice location

3223 E 31St St
Tulsa, OK 74105-2452

Mailing address

3223 E 31St St
Tulsa, OK 74105-2452
Phone (918) 250-7093

Other names 1

  • Macy Ann Davenport Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241231000587 OK Practitioner - Occupational Therapist in Private Practice 8426585548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tulsa Bone and Joint Associates PCGroup PAC ID 9335033802, 91 clinicians

Practice addresses (Care Compare)

4802 S 109TH E Ave
Tulsa, OK 74146-5822
Phone (918) 392-1513

4808 S 109TH E Ave
Tulsa, OK 74146-5822
Phone (918) 392-1513

9455 N Owasso Expy
Suite K
Owasso, OK 74055-5442
Phone (918) 392-1513

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tulsa Bone & Joint Associates PC CurrentSince Nov 21, 2024 Accepting new patients
Therapysource for Kids, Inc. CurrentSince Mar 3, 2024 Accepting new patients
Mighty Oaks PLLC Past Accepting new patients

Locations

9455 N Owasso Expy
Ste K
Owasso, OK 74055
Phone (918) 392-1513

3223 E 31st St
Tulsa, OK 74105
Phone (918) 250-7093

4802 S 109th East Ave
Tulsa, OK 74146
Phone (918) 392-1513

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1601

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1053177063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3223 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741052452",
            "telephone_number": "918-250-7093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741052452",
            "telephone_number": "918-250-7093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MACY",
        "middle_name": "ANN",
        "credential": "OTD, OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACY",
            "last_name": "DAVENPORT",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.