Benjmamin Thomas Carlson, PTA

Primary specialty

Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X

License

13747 Issued in AZ

Practice address

5314 N 7TH St
Phoenix, AZ 85014-2805

Phone

(602) 277-5006

NPI assigned

May 1, 2018

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1013405497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 E WATSON DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852833034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5314 N 7TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142805",
            "telephone_number": "602-277-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "BENJMAMIN",
        "middle_name": "THOMAS",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-01",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "AZ",
            "license": "13747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Carlos-Medina, FNP
• Mara Lena Carlos
• Carin M Carlsen, M.A. CCC-SLP
• Carlson & Palmer PC
• Aimee Carlson, PHARMD
• Breanna Carlson
• Breanna Kay Carlson, DO
• Calli Carlson
• Kathryn Carlson
• Kelly Blanche Carlson, M.C.

• Pediatric Neurodevelopmental Disabilities Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pediatric Neurodevelopmental Disabilities Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; 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.