Individual provider Active NPI

Richard Lee Carl Jr., APRN, FNP-C

  • Family Nurse Practitioner
  • Longview, TX
National Provider Identifier
1346901113
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1058631 Issued in TX
Practice address
701 E Marshall Ave Ste 502
Longview, TX 75601-5577
Phone
(903) 315-4435
NPI assigned
Jan 4, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1058631 TX Primary

Addresses

Primary practice location

701 E Marshall Ave Ste 502
Longview, TX 75601-5577

Mailing address

322 Bridgers Hill Rd
Longview, TX 75604-9630
Phone (903) 738-2283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220203001146 TX Practitioner - Nurse Practitioner 8527451152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

3133 Good Shepherd Way
Longview, TX 75605-7921
Phone (903) 315-4422

323 E Hawkins Pkwy
Longview, TX 75605-8153

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

700 E Marshall Ave
Christus Trinity Clinic
Longview, TX 75601-5580
Phone (903) 315-1488

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

  • Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1058631TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Mar 14, 2022 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Mar 14, 2022 Accepting new patients

Locations

3133 Good Shepherd Way
Longview, TX 75605
Phone (903) 315-4422

701 E Marshall Ave
Ste 502
Longview, TX 75601
Phone (903) 315-4435

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: rcarl232042@christushealth.direct-ci.net

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1346901113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 BRIDGERS HILL RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756049630",
            "telephone_number": "903-738-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E MARSHALL AVE STE 502",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015577",
            "telephone_number": "903-315-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARL",
        "first_name": "RICHARD",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1058631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.