Jeffrey James Carlson, M ED, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

2104 Northdale Blvd NW
Suite 100
Coon Rapids, MN 55433-3005

Phone

(763) 755-5495

NPI assigned

Nov 12, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003987132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3777 114TH LN NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332607",
            "telephone_number": "763-323-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 NORTHDALE BLVD NW",
            "address_2": "SUITE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333005",
            "telephone_number": "763-755-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "JEFFREY",
        "middle_name": "JAMES",
        "credential": "M ED, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Carey, RDH
• Lindsay Carik
• Caring Chiropractic Center, P.a.
• Melanie Carlson-Kappes, MA, LMFT
• Daniel Carlson, DO
• Lindsay Myrene Carlson, OTD, OTR/L
• Sharon Sweeney Carmody, MD
• Cassandra Joice Carney, MASSAGE THERAPIST
• Laura Christina Carroll-Contreras, MD
• Sara Carroll, MA,CCC-SLP

• Athletic Trainer in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Athletic Trainer in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.