Active NPI
Lynn B Carlson
- Gynecology Physician
- Wyomissing, PA
National Provider Identifier
1376531046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- MD-031351-E
- Practice address
- 1040 Reed Ave
Wyomissing, PA 19610-2029 - Phone
- (610) 898-7040
- Fax
- (610) 376-8239
- NPI assigned
- Oct 7, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | MD-031351-E | PA | Primary |
Addresses
Primary practice location
1040 Reed Ave
Wyomissing, PA 19610-2029
Mailing address
PO Box 13579
Reading, PA 19612-3579
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001562050 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD-031351-E | PA | MD | Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ages, PC | Gynecology | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482883200000",
"number": "1376531046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 13579",
"city": "READING",
"state": "PA",
"postal_code": "196123579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 REED AVE",
"city": "WYOMISSING",
"state": "PA",
"postal_code": "196102029",
"telephone_number": "610-898-7040",
"fax_number": "610-376-8239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "LYNN",
"middle_name": "B",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-07",
"last_updated": "2016-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "PA",
"license": "MD-031351-E",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001562050",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wyomissing, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.