Individual provider Active NPI

Sharon E. Carswell, M.D.

  • Family Medicine Physician
  • Caldwell, ID
National Provider Identifier
1710013628
Registry record updated Jul 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M9681 Issued in ID
Practice address
211 E Logan St
Suite 303
Caldwell, ID 83605-4882
Phone
(208) 459-4667
Fax
(208) 459-3372
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2009

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 M9681 ID Primary

Addresses

Primary practice location

211 E Logan St
Suite 303
Caldwell, ID 83605-4882

Mailing address

211 E Logan St
Suite 303
Caldwell, ID 83605-4882
Phone (208) 459-4667

Other identifiers 1

IdentifierTypeStateIssuer
807192600MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20090520000272 ID Practitioner - Family Practice 3678622768 Practice locations: Boise, ID; Meridian, ID; Emmett, ID

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M9681IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Valley Medical Group LLC PastSince Oct 1, 2006 Accepting new patients
Caldwell Internal Medicine Professional Association Past Accepting new patients
West Valley Medical Group Specialty Services LLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248652800000",
    "number": "1710013628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E LOGAN ST",
            "address_2": "SUITE 303",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054882",
            "telephone_number": "208-459-4667",
            "fax_number": "208-459-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E LOGAN ST",
            "address_2": "SUITE 303",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054882",
            "telephone_number": "208-459-4667",
            "fax_number": "208-459-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSWELL",
        "first_name": "SHARON",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2009-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M9681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807192600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.