NPIMap

Individual provider Active NPI

Paul James Carson, MD

  • Infectious Disease Physician
  • Fargo, ND
National Provider Identifier
1013935717
Registry record updated Jan 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
7510 Issued in ND
Practice address
801 Broadway N
Fargo, ND 58102-3641
Phone
(701) 234-4811
Fax
(701) 234-6979
NPI assigned
Jul 18, 2006
Last updated
Jan 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 7510 ND Primary

Addresses

Primary practice location

801 Broadway N
Fargo, ND 58102-3641

Mailing address

PO Box 2010
Fargo, ND 58122-0605

Other identifiers 1

IdentifierTypeStateIssuer
18812MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040507000143 ND Practitioner - Infectious DiseasePractitioner - Internal Medicine 7315936267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
University of North Dakota School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

5225 23Rd Ave S
Fargo, ND 58104-7927
Phone (701) 417-2575

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7510NDMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince May 23, 2011 Accepting new patients
Sanford Medical Center Fargo CurrentSince May 23, 2011 Accepting new patients
Sisters of Mary of the Presentation Long-Term Care PastSince Dec 1, 2020 Accepting new patients

Locations

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

736 Broadway N
Fargo, ND 58102
Phone (701) 234-2353

801 Broadway N
Fargo, ND 58102
Phone (701) 234-2371

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
SMP Health - St. RaphaelValley City, ND, CCN 355077 Skilled nursing facility Corporate Director Dec 1, 2020
SMP Health - MaryhillEnderlin, ND, CCN 355108 Skilled nursing facility Corporate Director Dec 1, 2020
SMP Health - St. Catherine NorthFargo, ND, CCN 355047 Skilled nursing facility Corporate Director Dec 1, 2020
SMP Health - St. Catherine SouthFargo, ND, CCN 355079 Skilled nursing facility Corporate Director Dec 1, 2020
SMP Health - Ave MariaJamestown, ND, CCN 355082 Skilled nursing facility Corporate Director Dec 1, 2020

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1013935717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2010",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581220605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023641",
            "telephone_number": "701-234-4811",
            "fax_number": "701-234-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "PAUL",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "ND",
            "license": "7510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18812",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.