Blake Danton Carroll, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

13869 Issued in TX

Practice address

6573 Old Jacksonville Hwy Ste 100
Tyler, TX 75703-0722

Phone

(903) 617-6106

Fax

(903) 617-6857

NPI assigned

Jul 18, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Flynn Chiropractic PCGroup PAC ID 1355663790, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Flynn Chiropractic PC

  • Chiropractor
  • Tyler, TX
  • NPI 1952670390
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1962988402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16104 BUCKBOARD CIR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757037504",
            "telephone_number": "903-316-4517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6573 OLD JACKSONVILLE HWY STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030722",
            "telephone_number": "903-617-6106",
            "fax_number": "903-617-6857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "BLAKE",
        "middle_name": "DANTON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "13869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Carpenter, LPC-A
• Kimberly Carpio
• James Carr, M.D.
• Jeffrey G Carr, MD
• Lindsey Ryan Carrington
• Deslyn Nicole Carroll, COTA
• Jocelynn Carroll
• Carrus Behavioral Hospital LLC
• Hope Ruth Carson, CF-SLP
• Jennifer Carson, NBC-HWC

• Chiropractor in Tyler, TX
• Providers in Tyler, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.