Individual provider Active NPI

John Ryan Veloro Carmona, PT, GCS, NCS

  • Neurology Physical Therapist
  • Tyler, TX
National Provider Identifier
1508171547
Registry record updated Aug 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology Physical TherapistTaxonomy code 2251N0400X
License
1092450 Issued in TX
Practice address
3814 Woods Blvd
Tyler, TX 75707-1677
Phone
(903) 941-1572
Fax
(903) 525-9211
NPI assigned
Aug 14, 2010
Last updated
Aug 14, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physical Therapist 2251N0400X 1092450 TX Primary

Addresses

Primary practice location

3814 Woods Blvd
Tyler, TX 75707-1677

Mailing address

3814 Woods Blvd
Tyler, TX 75707-1677
Phone (903) 941-1572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1092450TXMDNeurology Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1281744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281744000000",
    "number": "1508171547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3814 WOODS BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757071677",
            "telephone_number": "903-941-1572",
            "fax_number": "903-525-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3814 WOODS BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757071677",
            "telephone_number": "903-941-1572",
            "fax_number": "903-525-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMONA",
        "first_name": "JOHN RYAN",
        "middle_name": "VELORO",
        "name_prefix": "Mr.",
        "credential": "PT, GCS, NCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-14",
        "last_updated": "2010-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "TX",
            "license": "1092450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2010; 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.