Individual provider Active NPI

Carolyn R Telford, PA-C

  • Physician Assistant
  • Fort Worth, TX
National Provider Identifier
1235266412
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01356 Issued in TX
Practice address
2931 Oak Park Cir
Ft Worth, TX 76109-1891
Phone
(817) 924-3000
Fax
(817) 924-3010
NPI assigned
Feb 27, 2007
Last updated
Feb 20, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01356 TX Primary

Addresses

Primary practice location

2931 Oak Park Cir
Ft Worth, TX 76109-1891

Mailing address

2931 Oak Park Cir
Ft Worth, TX 76109-1891
Phone (817) 924-3000

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

State licenses

LicenseStateTypeSpecialty
PA01356TXMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392854400000",
    "number": "1235266412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2931 OAK PARK CIR",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761091891",
            "telephone_number": "817-924-3000",
            "fax_number": "817-924-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2931 OAK PARK CIR",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761091891",
            "telephone_number": "817-924-3000",
            "fax_number": "817-924-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELFORD",
        "first_name": "CAROLYN",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2014-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.