Bronwyn Dorothy Carlson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MT191616 Issued in PA

Practice address

11234 Anderson St
Loma Linda, CA 92354-2804

Phone

(909) 558-4000

NPI assigned

May 29, 2008

Sex

Female

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 NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bcarlson63723@direct.llu.edu

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.

• Pokroy Medical Group of Nevada, LTD.

  dba Pediatrix Medical Group of Nevada

  • Neonatal-Perinatal Medicine Physician
  • Las Vegas, NV
  • NPI 1992809412

  Pediatrics

  Medicare reassignment NPD
• Renown Regional Medical Center

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1124098421
  NPD (past)

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499040000000",
    "number": "1083872709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON STREET",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "BRONWYN",
        "middle_name": "DOROTHY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-29",
        "last_updated": "2017-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT191616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carie Alise Leilani Anderson
• Jonathan Carinan
• Hannah Lynn Galapon Caringal
• Demi Carlos, PA
• Bradley Allen Carlson
• Patricia Fay Carlson
• Taylor Marie Carlson
• Hannah Caron
• Kristin Anne Carr, MD
• Edmundo Carreon-Salazar, M.D.

• Pediatrics Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.