Tyler Nicholas Carruth, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.A10424 Issued in LA

Practice address

8742 Goodwood Blvd
Baton Rouge, LA 70806-7915

Phone

(225) 893-0810

NPI assigned

Oct 28, 2008

Last updated

Oct 28, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1649423278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44158",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708044158",
            "telephone_number": "281-787-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8742 GOODWOOD BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708067915",
            "telephone_number": "225-893-0810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRUTH",
        "first_name": "TYLER",
        "middle_name": "NICHOLAS",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.A10424",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03418",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andres Carrion- Vargas, M.D.
• Cleo Carroll
• Gina Carroll
• Kaleigh Allyn Carroll
• Melissa H Carroll, FNP-C
• Brittaney Renae Carson, M.S., CCC-SLP
• Donald C. Carson, D.O.
• Carter Chiropractic
• Adam Jude Carter, MD
• Angelique Carter

• Physician Assistant in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.