Individual provider Active NPI

Karen Lynne Carson, M.D.

  • Pediatrics Physician
  • Roswell, NM
National Provider Identifier
1306898739
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2000-99 Issued in NM
Practice address
813 N Washington Ave
Roswell, NM 88201-3941
Phone
(575) 622-2606
Fax
(575) 622-6645
NPI assigned
May 16, 2006
Last updated
Jun 6, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2000-99 NM Primary

Addresses

Primary practice location

813 N Washington Ave
Roswell, NM 88201-3941

Mailing address

813 N Washington Ave
Roswell, NM 88201-3941
Phone (575) 622-2606

Other identifiers 1

IdentifierTypeStateIssuer
77485MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20171005002953 NM Practitioner - Pediatric Medicine 8325265283

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2000-99NMMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Cardiology of New Mexico, P.C. PastSince Aug 16, 2017 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1306898739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 N WASHINGTON AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013941",
            "telephone_number": "575-622-2606",
            "fax_number": "575-622-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 N WASHINGTON AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013941",
            "telephone_number": "575-622-2606",
            "fax_number": "575-622-6645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "KAREN",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "2000-99",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77485",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.