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Deactivated NPI 1023104734 Deactivated / Inactive NPI Male Practitioner

Dr. Burt S. Carlson , OD

Optometrist • Madison, OH

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Burt Carlson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 04, 2006
NPI Deactivation Date September 30, 2019
Total Practice Duration ~13 Years of Practice (2006 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. Burt Carlson, OD was a registered Optometrist practicing in Madison, OH. Throughout an active medical career spanning 13 years, Dr. Carlson provided care at the practice location at 6067 NORTH RIDGE ROAD until profile deactivation on 2019-09-30.

Practice Location & Contact Primary Location

Practice Address

6067 North Ridge Road

Madison, OH 44057

Telephone 4404170109
Fax 4404170108

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Madison, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 20.3 Yrs
State Avg: 23.4 Yrs
Regional Practice Density
5 Specialists

Practicing in Madison, OH (2535 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License OH 3929/T1758

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Beth Brown

Technician/Technologist - Optician

NPI 1205624087
Kristen Whitney

Technician/Technologist - Optician

NPI 1295549293
NPI 1497738512

Doctor of Optometry

Alyssa Ricci

Technician/Technologist - Optician

NPI 1518664192
Brittany Knight

Technician/Technologist - Optician

NPI 1871290759

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 30, 2019

Record deactivated on September 30, 2019

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 6067 NORTH RIDGE ROAD, MADISON, OH 44057 (Tel: 4404170109)

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Updated Business Mailing Address July 08, 2007

Registered at 516 JOANN DRIVE, CONNEAUT, OH 44030 (Tel: 4405991403)

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Provider Name / Credentials Updated July 08, 2007

Recorded as BURT CARLSON, O.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Optometrist (License #3929/T1758 in OH)

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Initial NPI Registration & Enumeration October 04, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1023104734
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 04, 2006
Last Update: July 08, 2007
Deactivation Date: September 30, 2019

Mailing Address

516 Joann Drive

Conneaut, OH 44030

Phone: 4405991403

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.