Individual provider Active NPI

Carolyn Starr, OT

  • Physical Therapist
  • Victoria, TX
National Provider Identifier
1710163522
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1018901 Issued in TX
Practice address
1905 Leary LN
Victoria, TX 77901-2818
Phone
(361) 573-0731
Fax
(361) 576-4804
NPI assigned
Jan 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1018901 TX Primary
Occupational Therapist 225X00000X 101544 TX

Addresses

Primary practice location

1905 Leary LN
Victoria, TX 77901-2818

Mailing address

1905 Leary LN
Victoria, TX 77901-2818
Phone (361) 573-0731

Other identifiers 5

IdentifierTypeStateIssuer
P01213010OtherRAILROAD MEDICARE
874T15OtherTXBC/BS #
874T15OtherTXBC/BS PROVIDER #
119587701MedicaidTX
119587707MedicaidTX

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
101544TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Medical Clinics, P.a. Past Accepting new patients
Region III Education Service Center Physical Therapist Past Accepting new patients
South Texas Medical Clinics, P.a. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383091200000",
    "number": "1710163522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 LEARY LN",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779012818",
            "telephone_number": "361-573-0731",
            "fax_number": "361-576-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 LEARY LN",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779012818",
            "telephone_number": "361-573-0731",
            "fax_number": "361-576-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARR",
        "first_name": "CAROLYN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-11",
        "last_updated": "2013-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1018901",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "101544",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01213010",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS #",
            "identifier": "874T15",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER #",
            "identifier": "874T15",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119587701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119587707",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; 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.