Individual provider Active NPI

Paula Carson

  • Family Nurse Practitioner
  • Leonardtown, MD
National Provider Identifier
1700288545
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R126335 Issued in MD
Practice address
26020 Point Lookout Rd
Leonardtown, MD 20650
Phone
(301) 475-8917
NPI assigned
Sep 24, 2014
Last updated
Jul 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R126335 MD Primary
Registered Nurse 163W00000X R126335 MD

Addresses

Primary practice location

26020 Point Lookout Rd
Leonardtown, MD 20650

Mailing address

26020 Point Lookout Rd
Leonardtown, MD 20650-2001
Phone (301) 475-8917

Other practice location 1

10095 Ward Rd
Dunkirk, MD 20754-2731
Phone (410) 257-0191

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL other Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160929001201 MD Practitioner - Nurse Practitioner 4183911597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Mary's County Health DepartmentGroup PAC ID 4183784846, 4 clinicians

Practice addresses (Care Compare)

21580 Peabody St
Leonardtown, MD 20650-2962
Phone (301) 475-4298

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's County Health Department CurrentSince Apr 15, 2022 Accepting new patients

Locations

21580 Peabody St
Leonardtown, MD 20650
Phone (301) 475-4298

19856 Three Notch Rd
Lexington Park, MD 20653
Phone (240) 434-6059

21625 Great Mills Rd
Lexington Park, MD 20653
Phone (301) 637-8331

29675 Point Lookout Rd
Mechanicsville, MD 20659
Phone (240) 434-6060

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1700288545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26020 POINT LOOKOUT RD",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502001",
            "telephone_number": "301-475-8917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26020 POINT LOOKOUT RD",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "20650",
            "telephone_number": "301-475-8917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10095 Ward Rd",
            "address_purpose": "LOCATION",
            "city": "Dunkirk",
            "state": "MD",
            "postal_code": "207542731",
            "country_code": "US",
            "telephone_number": "410-257-0191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARSON",
        "first_name": "PAULA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R126335",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R126335",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "other",
            "affiliation": "N",
            "endpointDescription": "other",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "26020 Point Lookout Rd",
            "city": "Leonardtown",
            "state": "MD",
            "country_code": "US",
            "postal_code": "206502001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Leonardtown, MD

Sources for this page

Verify at the official NPI Registry.