Individual provider Active NPI

Gregory B Carlson, MD

  • Family Medicine Physician
  • Denison, TX
National Provider Identifier
1386694438
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K0666 Issued in TX
Practice address
5012 S US Highway 75
Suite 300
Denison, TX 75020-4587
Phone
(903) 416-6025
Fax
(903) 416-6138
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K0666 TX Primary

Addresses

Primary practice location

5012 S US Highway 75
Suite 300
Denison, TX 75020-4587

Mailing address

5012 S US Highway 75 Ste 300
Attn Billing
Denison, TX 75020-4589
Phone (903) 416-6025

Other identifiers 1

IdentifierTypeStateIssuer
044508201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100720000074 TX Practitioner - Family Practice 2769514264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Southwestern Medical School at Dallas, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TexomacareGroup PAC ID 3678555307, 47 clinicians

Practice addresses (Care Compare)

5012 S US Hwy 75
Suite 300
Denison, TX 75020-4589
Phone (903) 416-6015

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions95
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K0666TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texomacare Family Medicine CurrentSince Jul 25, 1996 Accepting new patients
Texomacare Family Medicine CurrentSince Jul 25, 1996 Accepting new patients

Locations

5012 US Highway 75
Denison, TX 75020
Phone (903) 416-1726

5012 US Highway 75
Ste 100
Denison, TX 75020
Phone (903) 416-6325

5012 US Highway 75
Ste 300
Denison, TX 75020
Phone (903) 416-6025

Interoperability endpoints

  • Direct secure messaging: gregory.carlson@tc.eclinicaldirectplus.com

Organizations & group practices 2

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 4

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1386694438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 S US HIGHWAY 75 STE 300",
            "address_2": "ATTN BILLING",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750204589",
            "telephone_number": "903-416-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5012 S US HIGHWAY 75",
            "address_2": "SUITE 300",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750204587",
            "telephone_number": "903-416-6025",
            "fax_number": "903-416-6138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "GREGORY",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K0666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044508201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denison, TX

Sources for this page

Verify at the official NPI Registry.