Active NPI
Scott Allan Carlson, DO
- Family Medicine Physician
- Manistee, MI
National Provider Identifier
1750386199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- SC008093
- Practice address
- 2198 US 31 S
Manistee, MI 49660 - Phone
- (231) 723-3567
- NPI assigned
- Jun 14, 2005
- Last updated
- May 9, 2019
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | SC008093 | MI | Primary |
Addresses
Primary practice location
2198 US 31 S
Manistee, MI 49660
Mailing address
6227 Frankfort Hwy
Benzonia, MI 49616-8632
Phone (231) 882-9661
Other practice location 1
1525 E Beltline Ave NE
Ste 101
Grand Rapids, MI 49525-4598
Phone (616) 363-0055 ext. 60
Other practice location 2
2198 US 31 S
Manistee, MI 49660
Phone (231) 723-3567
Other practice location 3
224 Park Ave
Frankfort, MI 49635-9658
Phone (231) 352-2200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3015713 | Medicaid | MI |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC008093 | MI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557360000000",
"number": "1750386199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6227 FRANKFORT HWY",
"city": "BENZONIA",
"state": "MI",
"postal_code": "496168632",
"telephone_number": "231-882-9661",
"fax_number": "231-882-9616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2198 US 31 S",
"city": "MANISTEE",
"state": "MI",
"postal_code": "49660",
"telephone_number": "231-723-3567"
}
],
"practiceLocations": [
{
"address_1": "1525 E Beltline Ave NE",
"address_2": "Ste 101",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495254598",
"country_code": "US",
"telephone_number": "616-363-0055 x60",
"fax_number": "616-363-5180",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2198 US 31 S",
"address_purpose": "LOCATION",
"city": "Manistee",
"state": "MI",
"postal_code": "49660",
"country_code": "US",
"telephone_number": "231-723-3567",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "224 Park Ave",
"address_purpose": "LOCATION",
"city": "Frankfort",
"state": "MI",
"postal_code": "496359658",
"country_code": "US",
"telephone_number": "231-352-2200",
"fax_number": "231-352-2232",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARLSON",
"first_name": "SCOTT",
"middle_name": "ALLAN",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-14",
"last_updated": "2019-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "SC008093",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3015713",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manistee, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.