Individual provider Active NPI

Tyler Carter, DO

  • Family Medicine Physician
  • Barbourville, KY
National Provider Identifier
1376167049
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
05570 Issued in KY
Practice address
215 N Allison Ave
Barbourville, KY 40906-1336
Phone
(606) 546-9287
Fax
(864) 725-4883
NPI assigned
May 29, 2020
Last updated
Jul 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 05570 KY Primary

Addresses

Primary practice location

215 N Allison Ave
Barbourville, KY 40906-1336

Mailing address

PO Box 1150
Barbourville, KY 40906-5150
Phone (606) 546-9287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230823004602 KY Practitioner - Family Practice 7113327750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lincoln Memorial University Medical Department, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

315 Hospital Dr
Barbourville, KY 40906-7917
Phone (606) 546-4060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
05570KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barbourville Family Health Center Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
Barbourville Family Health Center Family Medicine Current Accepting new patients
Barbourville Family Health Center Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients

Locations

215 N Allison Ave
Barbourville, KY 40906
Phone (606) 546-9287

315 Hospital Dr
Ste 2
Barbourville, KY 40906
Phone (606) 546-4060

140 Bryan Blvd
Corbin, KY 40701
Phone (606) 523-2005

Interoperability endpoints

  • Direct secure messaging: tcarter289205@selfregional.direct-ci.net

Organizations & group practices 4

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": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1376167049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1150",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409065150",
            "telephone_number": "606-546-9287",
            "fax_number": "606-546-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N ALLISON AVE",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409061336",
            "telephone_number": "606-546-9287",
            "fax_number": "864-725-4883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "TYLER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-29",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "05570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barbourville, KY

Sources for this page

Verify at the official NPI Registry.