Active NPI
David Leon Carter, MD
- Diagnostic Radiology Physician
- Bad Axe, MI
National Provider Identifier
1669427704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 4301G48193
- Practice address
- 110 S Van Dyke Road
Bad Axe, MI 48413 - Phone
- (989) 269-9521
- Fax
- (989) 269-5209
- NPI assigned
- May 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 4301G48193 | MI | Primary |
Addresses
Primary practice location
110 S Van Dyke Road
Bad Axe, MI 48413
Mailing address
4420 Varsity Dr
Attn: Barb Simmons
Ann Arbor, MI 48108-2233
Phone (734) 677-7400
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3161589 | Medicaid | MI | |
| 300322263 | Other | MI | BS INDIVIDUAL ID |
| 300070480 | Other | MI | RR MEDICARE PIN |
| DE9602 | Other | MI | MEDICARE RR GRP PIN |
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 |
|---|---|---|---|
| 4301G48193 | MI | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242259200000",
"number": "1669427704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4420 VARSITY DR",
"address_2": "ATTN: BARB SIMMONS",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481082233",
"telephone_number": "734-677-7400",
"fax_number": "734-677-7400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 S VAN DYKE ROAD",
"city": "BAD AXE",
"state": "MI",
"postal_code": "48413",
"telephone_number": "989-269-9521",
"fax_number": "989-269-5209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "DAVID",
"middle_name": "LEON",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2009-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MI",
"license": "4301G48193",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3161589",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BS INDIVIDUAL ID",
"identifier": "300322263",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE PIN",
"identifier": "300070480",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR GRP PIN",
"identifier": "DE9602",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bad Axe, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.