Active NPI
Robert Bruce Carrick, P.A.
- Medical Physician Assistant
- Temple, TX
National Provider Identifier
1164465662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA03460
- Practice address
- 2401 S 31St St
Temple, TX 76508-0001 - Phone
- (254) 724-2111
- NPI assigned
- Jun 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA03460 | TX | Primary |
Addresses
Primary practice location
2401 S 31St St
Temple, TX 76508-0001
Mailing address
PO Box 847556
Dallas, TX 75284-7556
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00645995 | Other | TX | RAILROAD MEDICARE |
| 196367001 | Medicaid | TX | |
| 196367002 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Texas Oncology Associates, P.a. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Southwest Regional Cancer Center
- Hematology & Oncology Physician
- Austin, TX
- NPI 1760420491
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310947200000",
"number": "1164465662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 847556",
"city": "DALLAS",
"state": "TX",
"postal_code": "752847556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 S 31ST ST",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765080001",
"telephone_number": "254-724-2111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRICK",
"first_name": "ROBERT",
"middle_name": "BRUCE",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2011-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "PA03460",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00645995",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "196367001",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "196367002",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.