Individual provider Active NPI

Carolyne McLaren, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1558091058
Registry record updated May 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.009214 Issued in IL
Practice address
8355 Walnut Hill LN
Dallas, TX 75231-4219
Phone
(214) 466-6618
Fax
(469) 586-5909
NPI assigned
Jun 16, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2025

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2023043565 MO
Physician Assistant 363A00000X PA9116770 FL
Physician Assistant 363A00000X 3019 NE
Physician Assistant 363A00000X 10004606A IN
Physician Assistant 363A00000X 010-15359 NC
Physician Assistant 363A00000X 345740 LA
Physician Assistant 363A00000X PA00760 MS
Physician Assistant 363A00000X 085.009214 IL Primary

Addresses

Primary practice location

8355 Walnut Hill LN
Dallas, TX 75231-4219

Mailing address

8355 Walnut Hill LN
Dallas, TX 75231-4219
Phone (214) 466-6618

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PA9116770FLMDPhysician Assistant
085.009214ILMDPhysician Assistant
10004606AINMDPhysician Assistant
345740LAMDPhysician Assistant
2023043565MOMDPhysician Assistant
PA00760MSMDPhysician Assistant
010-15359NCMDPhysician Assistant
3019NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Callon Doc Physician Assistant PastSince Aug 11, 2024 Accepting new patients

Organizations & group practices 1

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": "1655337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747440000000",
    "number": "1558091058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8355 WALNUT HILL LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314219",
            "telephone_number": "214-466-6618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8355 WALNUT HILL LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314219",
            "telephone_number": "214-466-6618",
            "fax_number": "469-586-5909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAREN",
        "first_name": "CAROLYNE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-16",
        "last_updated": "2025-05-17",
        "certification_date": "2025-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2023043565",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116770",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "3019",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004606A",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "010-15359",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "345740",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00760",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.009214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2025; 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.