NPIMap

Individual provider Active NPI

Rodney Lynn Carry, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Shavano Park, TX
National Provider Identifier
1508852948
Registry record updated Jun 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
F6511 Issued in TX
Practice address
4085 De Zavala Rd
Suite 200
Shavano Park, TX 78249-2084
Phone
(210) 558-6288
Fax
(210) 558-6289
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X F6511 TX Primary

Addresses

Primary practice location

4085 De Zavala Rd
Suite 200
Shavano Park, TX 78249-2084

Mailing address

PO Box 65060
San Antonio, TX 78265-5060
Phone (210) 558-6288

Other identifiers 2

IdentifierTypeStateIssuer
F6511OtherTXTX MEDICAL LICENSE
173004601MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041115000070 TX Practitioner - Internal MedicinePractitioner - Geriatric Medicine 7719873959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
University of Texas Southwestern Medical School at Dallas, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rise Up Rehab, LLCGroup PAC ID 3274861497, 118 clinicians

Practice addresses (Care Compare)

Shavano Park, TX 78249
Phone (210) 558-6288

16400 Blanco Rd
San Antonio, TX 78232-1902
Phone (210) 572-4954

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
R L Carry Inc Geriatric Medicine CurrentSince Jan 1, 2004 Accepting new patients
Methodist Healthcare System of San Antonio, LTD., L.L.P. Past Accepting new patients

Locations

7701 Broadway
Ste 5
San Antonio, TX 78209
Phone (210) 829-8063

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

4085 De Zavala Rd
Ste 200
Shavano Park, TX 78249
Phone 2105586288123

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Changing Seasons HospiceSan Antonio, TX, CCN 741740 Hospice Contracted Managing Employee Oct 9, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Aip Hospice, LLC

    dba Changing Seasons Hospice

    • Community Based Hospice Care Agency
    • San Antonio, TX
    • NPI 1821521907

    Contracted Managing Employee

    CMS ownership

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.

Hospital & facility affiliations 5

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": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465603200000",
    "number": "1508852948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 65060",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782655060",
            "telephone_number": "210-558-6288",
            "fax_number": "210-558-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4085 DE ZAVALA RD",
            "address_2": "SUITE 200",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782492084",
            "telephone_number": "210-558-6288",
            "fax_number": "210-558-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRY",
        "first_name": "RODNEY",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2016-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "F6511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX MEDICAL LICENSE",
            "identifier": "F6511",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173004601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shavano Park, TX

Sources for this page

Verify at the official NPI Registry.