Individual provider Active NPI

Nikolas Doyle Carnathan, OTR/L

  • Occupational Therapist
  • Tupelo, MS
National Provider Identifier
1437140415
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT1521 Issued in MS
Practice address
499 Gloster Creek VLG
Suite I-3
Tupelo, MS 38801-4600
Phone
(662) 844-4471
Fax
(662) 844-4472
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT1521 MS Primary

Addresses

Primary practice location

499 Gloster Creek VLG
Suite I-3
Tupelo, MS 38801-4600

Mailing address

499 Gloster Creek VLG
Suite I-3
Tupelo, MS 38801-4600
Phone (662) 844-4471

Other identifiers 1

IdentifierTypeStateIssuer
03784371MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050427000403 MS Practitioner - Occupational Therapist in Private Practice 2860431269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

2714 W Oxford Loop
Suite 164
Oxford, MS 38655-5714
Phone (662) 232-8949

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT1521MSMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico LTD Occupational Therapist CurrentSince Jun 25, 2022 Accepting new patients
Athletico LTD Occupational Therapist CurrentSince Jun 25, 2022 Accepting new patients
Functional Therapy Center, Inc. Occupational Therapist PastSince Apr 26, 2005 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

2714 West Oxford Loop
Ste 164
Oxford, MS 38655
Phone (662) 232-8949

105B Quality Ln
Senatobia, MS 38668
Phone (662) 562-9977

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1437140415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 GLOSTER CREEK VLG",
            "address_2": "SUITE I-3",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014600",
            "telephone_number": "662-844-4471",
            "fax_number": "662-844-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 GLOSTER CREEK VLG",
            "address_2": "SUITE I-3",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014600",
            "telephone_number": "662-844-4471",
            "fax_number": "662-844-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNATHAN",
        "first_name": "NIKOLAS",
        "middle_name": "DOYLE",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT1521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03784371",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.