NPIMap

Individual provider Active NPI

Raymond Lionel Carlson, D.O.

  • Internal Medicine Physician
  • North Platte, NE
National Provider Identifier
1194717413
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
224 Issued in NE
Practice address
625 W William Ave Ste 210
North Platte, NE 69101-0026
Phone
(308) 568-3500
Fax
(308) 568-3738
NPI assigned
Aug 22, 2005
Last updated
Sep 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 224 NE Primary

Addresses

Primary practice location

625 W William Ave Ste 210
North Platte, NE 69101-0026

Mailing address

625 W William Ave Ste 210
North Platte, NE 69101-0026
Phone (308) 568-3730

Other identifiers 2

IdentifierTypeStateIssuer
10025770900MedicaidNE
47080978500MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20051017000871 NE Practitioner - Internal Medicine 1052337326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

601 W Leota St
North Platte, NE 69101-6525

625 W William Ave
North Platte, NE 69101-0026

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224NEMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
North Platte Nebraska Hospital Corporation CurrentSince Sep 10, 2023 Accepting new patients
North Platte Care Center, LLC Past Accepting new patients
Birch at Sutherland LLC Past Accepting new patients
Box Butte General Hospital Past Accepting new patients

Locations

601 W Leota St
North Platte, NE 69101
Phone (308) 534-2288

611 W Francis St
Ste 160
North Platte, NE 69101
Phone (308) 568-3500

625 W William Ave
#210
North Platte, NE 69101

625 W William Ave
Ste 130
North Platte, NE 69101
Phone (308) 568-7390

625 W William Ave
Ste 210
North Platte, NE 69101
Phone (308) 568-3500

Interoperability endpoints

  • Direct secure messaging: rcarlson196902@direct.nebraskamed.com

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

Hospital & facility affiliations 11

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": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1194717413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 W WILLIAM AVE STE 210",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691010026",
            "telephone_number": "308-568-3730",
            "fax_number": "308-568-3738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W WILLIAM AVE STE 210",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691010026",
            "telephone_number": "308-568-3500",
            "fax_number": "308-568-3738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "RAYMOND",
        "middle_name": "LIONEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025770900",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47080978500",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Platte, NE

Sources for this page

Verify at the official NPI Registry.