Kevin E Carlson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0053636 Issued in MD

Practice address

10700 Charter Dr
Ste 200
Columbia, MD 21044-3629

Phone

(410) 910-7444

Fax

(410) 910-2310

NPI assigned

Sep 6, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2010 through Jul 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23291/brand/1/csg/1/fhir/r4

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.

• Charter Internal Medicine, LLC

  • Internal Medicine Physician
  • Marriottsville, MD
  • NPI 1750492419
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1811981905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 CHARTER DR",
            "address_2": "STE 200",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443629",
            "telephone_number": "410-910-7444",
            "fax_number": "410-910-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 CHARTER DR",
            "address_2": "STE 200",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443629",
            "telephone_number": "410-910-7444",
            "fax_number": "410-910-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KEVIN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-06",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0053636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MD",
            "identifier": "68747002",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "769200500",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF DC",
            "identifier": "B6100006",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caritas Christi
• Taylor S Carlin
• Taylor Paige Carlsen
• George Lewis Carlson Jr., PH.D.,LCSW-C
• Janice Bracalente Carlson, MSW
• Angela Carlyle
• Lilith Carmona
• Maria Carmona
• Rachel Carnie, M.S. CCC-SLP
• Jennifer M Carnucci, DPT

• Internal Medicine Physician in Columbia, MD
• Providers in Columbia, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.