NPIMap

Individual provider Active NPI

Vernette Marie Carlson, MD

  • Family Medicine Physician
  • Stephenson, MI
National Provider Identifier
1356440176
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
048831 Issued in MI
Practice address
S 926 US Hwy 41
Stephenson, MI 49887
Phone
(906) 753-4665
Fax
(906) 753-4366
NPI assigned
Sep 21, 2006
Last updated
Nov 23, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 048831 MI Primary
Family Medicine Physician 207Q00000X 26935020 WI

Addresses

Primary practice location

S 926 US Hwy 41
Stephenson, MI 49887

Mailing address

PO Box 400
Stephenson, MI 49887-0400
Phone (906) 753-4665

Other identifiers 2

IdentifierTypeStateIssuer
0805500152OtherMIBCBS
4654290MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040518000100 MI Practitioner - Family Practice 4183614464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carlson Medical PCGroup PAC ID 6305810250, 2 clinicians

Practice addresses (Care Compare)

S926 US Hwy 41
Stephenson, MI 49887-8808
Phone (906) 753-4665

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
048831MIMDFamily Medicine Physician
26935020WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carlson Medical PC Family Medicine CurrentSince Jul 2, 2004 Accepting new patients
NSH Menominee LLC Past Accepting new patients
Bay Area Medical Center Inc PastSince Sep 15, 2004 Accepting new patients

Locations

N306 Maple St
Stephenson, MI 49887
Phone (906) 753-2231

S926 US Highway 41
Stephenson, MI 49887
Phone (906) 753-4665

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Menominee Health ServicesMenominee, MI, CCN 235558 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 6, 2024
Oct 6, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • NSH Menominee LLC

    dba Menominee Health Services

    • Skilled Nursing Facility
    • Menominee, MI
    • NPI 1275176133

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Organizations & group practices 3

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 6

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1356440176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "STEPHENSON",
            "state": "MI",
            "postal_code": "498870400",
            "telephone_number": "906-753-4665",
            "fax_number": "906-753-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S 926 US HWY 41",
            "city": "STEPHENSON",
            "state": "MI",
            "postal_code": "49887",
            "telephone_number": "906-753-4665",
            "fax_number": "906-753-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "VERNETTE",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "048831",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "26935020",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0805500152",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4654290",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stephenson, MI

Sources for this page

Verify at the official NPI Registry.