R Lynn Carlson MD PC Medicenter

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

R LYNN CARLSON MD PC MEDICENTER

Practice address

10543 Kenai Spur Hwy
Kenai, AK 99611-7812

Phone

(907) 283-9118

Fax

(907) 283-5341

NPI assigned

Jan 22, 2009

Organization subpart

No

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

Authorized official

Name

R Lynn Carlson, MD

Title

Managing Physician

Phone

(907) 283-9118

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MediCenter Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• R Lynn Carlson MD PC Medicenter

  • Medical Physician Assistant
  • Nikiski, AK
  • NPI 1215385794
  NPPES parent name

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392336000000",
    "number": "1811135247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10543 KENAI SPUR HWY",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117812",
            "telephone_number": "907-283-9118",
            "fax_number": "907-283-5341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10543 KENAI SPUR HWY",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996117812",
            "telephone_number": "907-283-9118",
            "fax_number": "907-283-5341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R LYNN CARLSON MD PC MEDICENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-22",
        "last_updated": "2014-02-14",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "R LYNN",
        "authorized_official_title_or_position": "MANAGING PHYSICIAN",
        "authorized_official_telephone_number": "907-283-9118",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MPG0152",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MediCenter",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• RC Dental, LLC
• Reclaiming Wellness, LLC
• Redoubt Medical Group LLC.

• Family Medicine Physician in Kenai, AK
• Providers in Kenai, AK by specialty
• Family Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.