John Caudell Carson, D.O.
Individual provider Active NPI Family Medicine Physician · Richland, MO
NPI 1164425575 · NPPES record last updated Jul 29, 2024
Key facts
- NPI
- 1164425575
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- DO.000127 (LA)
- Practice address
- 304 W Washington Ave
Richland, MO 65556-7101 - Phone
- (877) 406-2662
- Fax
- (573) 723-1474
- NPI assigned
- May 31, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- At Still University of Health Sciences, College of Osteo Med, Kirksville, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Richland Medical Center, Inc.
Practice addresses (Care Compare)
1652 N Business Route 5
Camdenton, MO 65020-6872
Phone (877) 406-2662
304 W Washington Ave
Richland, MO 65556-7101
Phone (573) 836-7053
Hospital & facility affiliations
- Richland Care Center Inc
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240813002224 | MO | Practitioner - Family Practice | 1052355690 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO.000127 | LA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richland Medical Center, Inc. | Current | Accepting new patients | |
| Richland Medical Center, Inc. | Past | Accepting new patients | |
| Ozarks Medical Center | Family Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2024028733 | MO | |
| Family Medicine Physician | 207Q00000X | DO.000127 | LA | Yes |
Addresses
Primary practice location
304 W Washington Ave
Richland, MO 65556-7101
Mailing address
304 W Washington Ave
Richland, MO 65556-7101
Phone (877) 406-2662
Other practice location 1
30 Lakeview Drive
Camdenton, MO 65020
Phone (573) 814-6580
Other providers in Richland, MO
- Kristi D Atkins
- Kelvin Eugene Bailey
- Samantha Kay Belen
- Blessed Assurance Counseling, LLC
- Ellen Brown
- Earleen F Cashill
- Amanda Katherine Cummings
- Megan Davault
- Elizabeth C Ewers Teel
- Rachel Fenton
All providers in Richland, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.