Carlson N Foma, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209016216 Issued in IL

Practice address

1005 Broadway St
Quincy, IL 62301-2834

Phone

(217) 223-8400

NPI assigned

Jun 7, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, DC, MD3 enrollments

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Company LLCGroup PAC ID 4587559026, 373 clinicians

Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

First Colonies Anesthesia Associates, LLCGroup PAC ID 8426039744, 339 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Frederick Health Hospital Hospital, Frederick, MD, CCN 210005
• Medstar Southern Maryland Hospital Center Hospital, Clinton, MD, CCN 210062
• University of MD Capital Region Medical Center Hospital, Upper Marlboro, MD, CCN 210003
• Holy Cross Germantown Hospital Hospital, Germantown, MD, CCN 210065

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cfoma925176@direct.umm.edu

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.

• Anesthesia Company, LLC

  • Anesthesiology Physician
  • Annapolis, MD
  • NPI 1871548156

  DC, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• First Colonies Anesthesia Associates, LLC

  • Anesthesiology Physician
  • Columbia, MD
  • NPI 1740218767

  DC, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187

  DC

  Medicare reassignment Care Compare group NPD
• Medstar Medical Group Anesthesiology LLC

  • Anesthesiology Physician
  • Baltimore, MD
  • NPI 1528578333

  DC

  Medicare reassignment NPD
• North American Partners in Anesthesia Maryland LLC

  • Anesthesiology Physician
  • Prince Frederick, MD
  • NPI 1093707879

  DC

  Medicare reassignment NPD
• Medstar Medical Group Anesthesiology LLC

  • Anesthesiology Physician
  • Washington, DC
  • NPI 1558976175
  NPD
• Frederick Health Hospital Inc

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

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dimensions Health Corporation

  • General Acute Care Hospital
  • Upper Marlboro, MD
  • NPI 1720099286
  Care Compare affiliation
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  Care Compare affiliation
• Holy Cross Health, Inc.

  • General Acute Care Hospital
  • Germantown, MD
  • NPI 1245655638
  Care Compare affiliation
• Medstar Southern Maryland Hospital Center Inc

  • General Acute Care Hospital
  • Clinton, MD
  • NPI 1366790693
  Care Compare affiliation

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1841729589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMA",
        "first_name": "CARLSON",
        "middle_name": "N",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209016216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shelly Arlene Flachs, LCSW
• Jessica Jean Fleer, LPC
• Stephanie Blythe Flesner
• Kellie Elizabeth Flippin, MD
• Shannon T Foley, OT
• Brooke Foose, MSW, LSW
• Jessica Marie Foster, BA
• Angela Nicole Frageman, SLP
• Janis Lynn Frageman, BA
• Diane Elizabeth Frankenhoff, RN

• Certified Registered Nurse Anesthetist in Quincy, IL
• Providers in Quincy, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.