Individual provider Active NPI

Taylor Renea Carson, PA-C

  • Physician Assistant
  • Enid, OK
National Provider Identifier
1619433547
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3032 Issued in OK
Practice address
5320 W Chestnut Ave
Enid, OK 73703-3563
Phone
(580) 701-0100
NPI assigned
Feb 15, 2019
Last updated
Jun 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3032 OK Primary

Addresses

Primary practice location

5320 W Chestnut Ave
Enid, OK 73703-3563

Mailing address

405 S Oklahoma Ave
Cherokee, OK 73728-2545
Phone (580) 596-2800

Other practice location 1

405 S Oklahoma Ave
Cherokee, OK 73728-2545
Phone (580) 596-2800

Other practice location 2

231 S 30th St
Enid, OK 73701-6455
Phone (580) 233-2900

Other practice location 3

16603 W South Ave
Tonkawa, OK 74653-4707
Phone (580) 557-0069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190402000165 OK Practitioner - Physician Assistant 4587905559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1106 E Broadway Ave
Enid, OK 73701-4411
Phone (580) 596-2800

231 S 30TH St
Enid, OK 73701-6455
Phone (580) 596-2800

405 S Oklahoma Ave
Cherokee, OK 73728-2545
Phone (580) 596-2800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3032OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Great Salt Plains Health Center, Inc. CurrentSince Feb 11, 2019 Accepting new patients
Great Salt Plains Health Center, Inc. CurrentSince Feb 11, 2019 Accepting new patients
Integris Bass Baptist Health Center Past Accepting new patients
Uhs of Oklahoma, LLC Past Accepting new patients

Locations

310 E Walnut
Canton, OK 73724
Phone (580) 886-2200

405 S Oklahoma Ave
Cherokee, OK 73728
Phone 87724284756012

1106 E Broadway Ave
Enid, OK 73701
Phone (580) 886-2200

231 S 30th St
Enid, OK 73701
Phone (580) 215-7555

2615 E Randolph Ave
Enid, OK 73701
Phone (580) 234-3734

5320 W Chestnut Ave
Enid, OK 73703
Phone (580) 233-2900

619 N Front St
Medford, OK 73759
Phone (580) 395-3200

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1550188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1619433547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S OKLAHOMA AVE",
            "city": "CHEROKEE",
            "state": "OK",
            "postal_code": "737282545",
            "telephone_number": "580-596-2800",
            "fax_number": "580-596-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 W CHESTNUT AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737033563",
            "telephone_number": "580-701-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 S Oklahoma Ave",
            "address_purpose": "LOCATION",
            "city": "Cherokee",
            "state": "OK",
            "postal_code": "737282545",
            "country_code": "US",
            "telephone_number": "580-596-2800",
            "fax_number": "580-596-2805",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "231 S 30th St",
            "address_purpose": "LOCATION",
            "city": "Enid",
            "state": "OK",
            "postal_code": "737016455",
            "country_code": "US",
            "telephone_number": "580-233-2900",
            "fax_number": "580-596-2805",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16603 W South Ave",
            "address_purpose": "LOCATION",
            "city": "Tonkawa",
            "state": "OK",
            "postal_code": "746534707",
            "country_code": "US",
            "telephone_number": "580-557-0069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARSON",
        "first_name": "TAYLOR",
        "middle_name": "RENEA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-15",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "3032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.