NPIMap

Individual provider Active NPI

Beth L Carlson, M.D.

  • Family Medicine Physician
  • Matthews, NC
National Provider Identifier
1366443392
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200500019 Issued in NC
Practice address
4105 Matthews Mint Hill Rd
Matthews, NC 28105-3633
Phone
(704) 384-9920
Fax
(704) 384-9925
NPI assigned
Aug 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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 200500019 NC Primary
Family Medicine Physician 207Q00000X ME104131 FL

Addresses

Primary practice location

4105 Matthews Mint Hill Rd
Matthews, NC 28105-3633

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-9920

Other identifiers 1

IdentifierTypeStateIssuer
001278800MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bcarlson418588@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20050328000908 NC Practitioner - Family Practice 4284680760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of Ny Upstate Medical University, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrium Health North Market Network LLCGroup PAC ID 1557743440, 158 clinicians

Practice addresses (Care Compare)

4815 Johnston Oehler Rd
Suite 100
Charlotte, NC 28269-1065
Phone (704) 801-7310

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Atrium Health Union Hospital, Monroe, NC, CCN 340130

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atrium Health North Market Network LLC Family Medicine CurrentSince Jan 3, 2023 Accepting new patients
Jordan & Prieto PA Family Medicine Past Accepting new patients
Baycare Urgent Care, LLC Family Medicine Past Accepting new patients
Primary Care Medical Associates, Inc. Family Medicine Past Accepting new patients
Bayfront Enterprises Inc Past Accepting new patients
Primary Care Medical Associates Inc Family Medicine Past Accepting new patients

Locations

4525 Cameron Valley Pkwy
Ste 4100D
Charlotte, NC 28211
Phone (704) 801-7310

4815 Johnston Oehler Rd
#100
Charlotte, NC 28269
Phone (704) 801-7310

Interoperability endpoints

  • Direct secure messaging: bcarlson1090804@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: bcarlson418588@direct.novanthealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 7

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": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1366443392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-9920",
            "fax_number": "704-384-9925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 MATTHEWS MINT HILL RD",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281053633",
            "telephone_number": "704-384-9920",
            "fax_number": "704-384-9925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "BETH",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-01",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200500019",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME104131",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001278800",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bcarlson418588@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "4105 Matthews Mint Hill Rd",
            "city": "Matthews",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281053633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.