Deslyn Nicole Carroll, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

209842 Issued in TX

Practice address

3505 Old Jacksonville Rd
Tyler, TX 75701-8510

Phone

(903) 561-2011

NPI assigned

Oct 1, 2007

Last updated

Oct 1, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1407043672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 OLD JACKSONVILLE RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018510",
            "telephone_number": "903-561-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 OLD JACKSONVILLE RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018510",
            "telephone_number": "903-561-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "DESLYN",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "209842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Carpio
• James Carr, M.D.
• Jeffrey G Carr, MD
• Lindsey Ryan Carrington
• Blake Danton Carroll, DC
• Jocelynn Carroll
• Carrus Behavioral Hospital LLC (Carrus Care Tyler)
• Hope Ruth Carson, CF-SLP
• Jennifer Carson, NBC-HWC
• Kelly Hays Carson

• Occupational Therapy Assistant in Tyler, TX
• Providers in Tyler, TX by specialty
• Occupational Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.