Individual provider Active NPI

Karen D Carroll, FNP

  • Primary Care Nurse Practitioner
  • Jbsa Lackland, TX
National Provider Identifier
1063907772
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP138568 Issued in TX
Practice address
1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
Phone
(210) 292-7411
NPI assigned
Jun 25, 2018
Last updated
Mar 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AP138568 TX Primary
Primary Care Clinic/Center 261QP2300X AP138568 TX

Addresses

Primary practice location

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638

Mailing address

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, HI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180914001712 TX Practitioner - Nurse Practitioner 7618228511 Reassigns benefits to 1 organization
I20190712001915 HI Practitioner - Nurse Practitioner 7618228511 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMC Provider Group PLLCGroup PAC ID 6305149121, 213 clinicians

Practice addresses (Care Compare)

11811 Blanco Rd
San Antonio, TX 78216-2407
Phone (210) 341-5588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP138568TXMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Provider Group PLLC CurrentSince Mar 2, 2026 Accepting new patients
TMC Provider Group, PLLC CurrentSince Mar 2, 2026 Accepting new patients
Kau Hospital CurrentSince Sep 30, 2019 Accepting new patients
Hilo Benioff Medical Center CurrentSince May 7, 2019 Accepting new patients
Kau Hospital CurrentSince Sep 30, 2019 Accepting new patients
Hilo Benioff Medical Center CurrentSince May 7, 2019 Accepting new patients
GLC Wellness Center Texas LLC PastSince Jan 1, 2022 Accepting new patients
Hilo Benioff Medical Center Past Accepting new patients

Locations

1190 Waianuenue Ave
Hilo, HI 96720
Phone (808) 932-3000

1190 Waianuenue Ave
Fl 1
Hilo, HI 96720

1285 Waianuenue Ave
#2
Hilo, HI 96720

75 Puuhonu Pl
Ste 100
Hilo, HI 96720
Phone (808) 932-3940

9900 S Interstate 35
Austin, TX 78748
Phone (512) 291-5577

11811 Blanco Rd
San Antonio, TX 78216
Phone (210) 341-5588

Organizations & group practices 9

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": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1063907772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "KAREN",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP138568",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "AP138568",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Lackland, TX

Sources for this page

Verify at the official NPI Registry.