Mitchell R. Carlson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2899 Issued in MN

Practice address

5959 Baker Rd
Minnetonka, MN 55345-5900

Phone

(651) 348-7428

NPI assigned

Oct 13, 2006

Last updated

Sep 24, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1073603775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7581 9TH ST N STE 100",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551286635",
            "telephone_number": "651-748-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 BAKER RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553455900",
            "telephone_number": "651-348-7428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "229 Parrish Street",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Canandaigua",
            "state": "NY",
            "postal_code": "14424",
            "country_code": "US",
            "telephone_number": "585-394-3920",
            "fax_number": "585-394-3997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "MITCHELL",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "014144",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "2899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "010114144",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "601318000",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7735556",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "020114144",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "145851FT",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra Elizabeth Carlone, M.D.
• Craig Carlson, LP
• Emily Carlson, PA-C
• Joseph Carlson, M.A., B.C.B.A
• Mackenzie Cathleen Carlson
• Taylor Nichole Ebnet Carlson, PT, ATC
• Charles Carodenuto, MD
• Bryn Elizabeth Carr, BA IN PSYCHOLOGY
• Laura Elizabeth Carroll, CRNP
• Rose Olson Carroll

• Physical Therapist in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.