Individual provider Active NPI

Carl F Dennison

  • Adolescent Medicine (Family Medicine) Physician
  • Ft Lauderdale, FL
National Provider Identifier
1114032109
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X
License
ME62956 Issued in FL
Practice address
3035 E Commercial Blvd
Ft Lauderdale, FL 33308-4347
Phone
(954) 776-4981
Fax
(954) 776-0146
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Family Medicine) Physician 207QA0000X ME62956 FL Primary

Addresses

Primary practice location

3035 E Commercial Blvd
Ft Lauderdale, FL 33308-4347

Mailing address

3035 E Commercial Blvd
Ft Lauderdale, FL 33308-4347
Phone (954) 776-4981

Other identifiers 1

IdentifierTypeStateIssuer
3752810000MedicaidFL

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME62956FLMDAdolescent Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Cross Hospital Inc Past Accepting new patients
Holy Cross Hospital, Inc Past Accepting new patients
Holy Cross Hospital Inc Adolescent Medicine Past Accepting new patients
Holy Cross Hospital, Inc Past Accepting new patients

Organizations & group practices 4

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114032109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 E COMMERCIAL BLVD",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084347",
            "telephone_number": "954-776-4981",
            "fax_number": "954-776-0146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 E COMMERCIAL BLVD",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084347",
            "telephone_number": "954-776-4981",
            "fax_number": "954-776-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNISON",
        "first_name": "CARL",
        "middle_name": "F",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "FL",
            "license": "ME62956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3752810000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.