Lawrence Douglas Carlson, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

MD209372 Issued in OR

Practice address

3001 Daggett Ave Ste 101
Klamath Falls, OR 97601-1126

Phone

(541) 884-6233

Fax

(541) 880-2840

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Cardiovascular Disease (Cardiology)

Education

Saint Louis University School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centennial Medical Group IncGroup PAC ID 6103982962, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center Hospital, Roseburg, OR, CCN 380027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Centennial Medical Group Inc.

  • Surgery Physician
  • Roseburg, OR
  • NPI 1518103274

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Medicare reassignment NPD
• Sky Lakes Medical Center Inc

  • Community/Retail Pharmacy
  • Klamath Falls, OR
  • NPI 1003654625
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Commonspirit Oregon

  • General Acute Care Hospital
  • Roseburg, OR
  • NPI 1477590198
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1639188972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2120",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972082120",
            "telephone_number": "541-884-6233",
            "fax_number": "541-882-2840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 DAGGETT AVE STE 101",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011126",
            "telephone_number": "541-884-6233",
            "fax_number": "541-880-2840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3475 Torrance Blvd",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905035800",
            "country_code": "US",
            "telephone_number": "310-370-3568",
            "fax_number": "310-316-9188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "LAWRENCE",
        "middle_name": "DOUGLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G62984",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "G62984",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD209372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00G629840",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G629840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly J Card, RPH
• Patricia Card
• Emily Michelle Cardoza
• Zachary Robert Cardoza
• Rebecca Jan Carlin
• Michaela Marie Carlson, FNP-C
• Madison J Carney
• Patricia A Carney, MS, QMHP
• Betty Charlene Carpenter, FNP
• Mackenzie Nicole Carpenter

• Cardiovascular Disease Physician in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• Cardiovascular Disease Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.