Individual provider Active NPI

Thomas Carl Carr, DPM

  • Podiatrist
  • Chicago, IL
National Provider Identifier
1316932668
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016004401 Issued in IL
Practice address
467 W Erie St
Chicago, IL 60654-5704
Phone
(312) 337-9900
Fax
(312) 337-9902
NPI assigned
Sep 13, 2005
Last updated
Feb 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016004401 IL Primary

Addresses

Primary practice location

467 W Erie St
Chicago, IL 60654-5704

Mailing address

467 W Erie St
Chicago, IL 60654-5704
Phone (312) 337-9900

Other identifiers 2

IdentifierTypeStateIssuer
60010789OtherILBCBS
016004401MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050504000409 IL Practitioner - Podiatry 9537137369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016004401ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
River North Surgical Suite Current Accepting new patients
Orthotec Surgery Center, Inc Current Accepting new patients

Locations

467 W Erie St
Chicago, IL 60654
Phone (312) 337-9900

340 W Butterfield Rd
Ste 1B
Elmhurst, IL 60126
Phone (331) 209-9903

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14157/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360627200000",
    "number": "1316932668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 W ERIE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606545704",
            "telephone_number": "312-337-9900",
            "fax_number": "312-337-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "467 W ERIE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606545704",
            "telephone_number": "312-337-9900",
            "fax_number": "312-337-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "THOMAS",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2013-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016004401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "60010789",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016004401",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.