Courtland Reid Carbol, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

M-9168 Issued in ID

Practice address

206 S Sunniva Ave
Kuna, ID 83634-5165

Phone

(208) 406-8941

Fax

(208) 238-8888

NPI assigned

Jun 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  General Practice, ID

  Medicare reassignment NPD

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1780610071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S SUNNIVA AVE",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836345165",
            "telephone_number": "208-406-8941",
            "fax_number": "208-238-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S SUNNIVA AVE",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836345165",
            "telephone_number": "208-406-8941",
            "fax_number": "208-238-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBOL",
        "first_name": "COURTLAND",
        "middle_name": "REID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M9168",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "ID",
            "license": "M-9168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brigham Murray Anesthesia LLC
• Colin Brown, PA-C
• Carolyn Jane Bryden, M.A.T.
• Stephen Kyle Burtenshaw, D.C.
• Susan Diane Cane, LMFT
• Charles Golightly
• Clarifeye, PC
• Sally Anderson Cleary, LPC
• Clemens Creative Counseling PLLC
• Samuel Clemens, LCSW

• All providers in Kuna, ID
• General Practice Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.