Individual provider Active NPI

Catherine Anne Gogela Carlson, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • West Columbia, SC
National Provider Identifier
1558517565
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
37237 Issued in SC
Practice address
2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone
(803) 936-7372
Fax
(803) 936-7102
NPI assigned
Aug 9, 2008
Last updated
Apr 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2013-01581 NC
Emergency Medicine Physician 207P00000X 21210 MN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 2013-01581 NC
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 37237 SC Primary

Addresses

Primary practice location

2720 Sunset Blvd
West Columbia, SC 29169-4810

Mailing address

PO Box 6069
West Columbia, SC 29171-6069
Phone (803) 936-7372

Other practice location 1

3001 Lyndhurst Ave
Winston Salem, NC 27103
Phone (336) 765-0383 ext. 182

Other practice location 2

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-1242

Other practice location 3

9330 Medical Plaza Dr
Charleston, SC 29406-9104
Phone (843) 797-7000

Other identifiers 2

IdentifierTypeStateIssuer
1558517565MedicaidNC
NC1910MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ccarlson145868@direct.lexmed.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130919000568 NC Practitioner - Critical Care (Intensivists)Practitioner - Emergency Medicine 5395933246 Reassigns benefits to 1 organization
I20181005001461 SC Practitioner - Critical Care (Intensivists) 5395933246 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
University of Colorado School of Medicine, Denver, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

555 E Cheves St
Florence, SC 29506-2617
Phone (843) 777-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21210MNMDEmergency Medicine Physician
2013-01581NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Regional Medical Center of the Pee Dee, Inc Single Specialty CurrentSince Jul 14, 2018 Accepting new patients
Lexington Health Inc Critical Care Medicine CurrentSince Sep 1, 2021 Accepting new patients
Lexington Health Inc Single Specialty Current Accepting new patients
Spectrum Medical Group PA Single Specialty CurrentSince Jul 30, 2018 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Jul 14, 2018 Accepting new patients
Lexington Health Inc CurrentSince Sep 1, 2021 Accepting new patients

Locations

3001 Lyndhurst Ave
Winston Salem, NC 27103
Phone (336) 765-0383

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

2720 Sunset Blvd
West Columbia, SC 29169
Phone (803) 791-2480

Interoperability endpoints

  • Direct secure messaging: catherine.carlson@hca5.eclinicaldirectplus.com
  • Direct secure messaging: ccarlson95641@directmcleodehealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1218240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1558517565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069",
            "telephone_number": "803-936-7372",
            "fax_number": "803-794-4317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694810",
            "telephone_number": "803-936-7372",
            "fax_number": "803-936-7102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3001 Lyndhurst Ave",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "27103",
            "country_code": "US",
            "telephone_number": "336-765-0383 x182",
            "fax_number": "336-760-6918",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1242",
            "fax_number": "704-446-1241",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9330 Medical Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294069104",
            "country_code": "US",
            "telephone_number": "843-797-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "CATHERINE",
        "middle_name": "ANNE GOGELA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-09",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2013-01581",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "21210",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NC",
            "license": "2013-01581",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "SC",
            "license": "37237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558517565",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC1910",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccarlson145868@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2720 Sunset Blvd",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.