Active NPI
Barbara S Carlson, M.D.
- Family Medicine Physician
- Stevensville, MI
National Provider Identifier
1710975529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301066504
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 01059984A | IN | MD | Family Medicine Physician |
| 4301066504 | MI | MD | Family 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.