Individual provider Active NPI

Barbara S Carlson, M.D.

  • Family Medicine Physician
  • Stevensville, MI
National Provider Identifier
1710975529
Registry record updated Jan 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301066504 Issued in MI
Practice address
5515 Cleveland Avenue
Lakeland Medical Practices Dba SWMC
Stevensville, MI 49127-9613
Phone
(261) 429-9644
Fax
(269) 429-4002
NPI assigned
Oct 6, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01059984A IN
Family Medicine Physician 207Q00000X 4301066504 MI Primary

Addresses

Primary practice location

5515 Cleveland Avenue
Lakeland Medical Practices Dba SWMC
Stevensville, MI 49127-9613

Mailing address

3950 Hollywood Rd
Suite 100
Saint Joseph, MI 49085-9159
Phone (269) 429-8010

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

LicenseStateTypeSpecialty
01059984AINMDFamily Medicine Physician
4301066504MIMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391126400000",
    "number": "1710975529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD",
            "address_2": "SUITE 100",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859159",
            "telephone_number": "269-429-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 CLEVELAND AVENUE",
            "address_2": "LAKELAND MEDICAL PRACTICES DBA SWMC",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279613",
            "telephone_number": "261-429-9644",
            "fax_number": "269-429-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "BARBARA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2014-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01059984A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301066504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevensville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.