Individual provider Active NPI

Christi Lynne Carlson, RN, FNP-C

  • Family Nurse Practitioner
  • Temple, TX
National Provider Identifier
1093146409
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
736626 Issued in TX
Practice address
2401 S 31St St
Temple, TX 76508-0001
Phone
(254) 724-2111
NPI assigned
Dec 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 736626 TX Primary

Addresses

Primary practice location

2401 S 31St St
Temple, TX 76508-0001

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Other practice location 1

1001 Arbor Park Drive
Belton, TX 76513
Phone (254) 831-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ccarlson30498@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131231001737 TX Practitioner - Nurse Practitioner 9234367947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Legacy Urgent Care PAGroup PAC ID 3072679828, 157 clinicians

Practice addresses (Care Compare)

7010 W Adams Ave
Suite 200
Temple, TX 76502-5550
Phone (844) 813-1749

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Urgent Care, PA CurrentSince Mar 19, 2024 Accepting new patients

Locations

330 S Denton Tap Rd
Coppell, TX 75019
Phone (469) 312-7777

9205 Legacy Dr
Frisco, TX 75033
Phone (972) 625-6020

2810 S Hardin Blvd
Ste 100
McKinney, TX 75072
Phone (972) 548-7277

8950 N Tarrant Pkwy
North Richlnd Hls, TX 76182
Phone (817) 281-7277

7010 W Adams Ave
Ste 200
Temple, TX 76502
Phone (254) 228-1200

Interoperability endpoints

  • Direct secure messaging: ccarlson30498@direct.sw.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1386720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1093146409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "254-724-2111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Arbor Park Drive",
            "address_purpose": "LOCATION",
            "city": "Belton",
            "state": "TX",
            "postal_code": "76513",
            "country_code": "US",
            "telephone_number": "254-831-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "CHRISTI",
        "middle_name": "LYNNE",
        "credential": "RN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-11",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "736626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccarlson30498@direct.sw.org",
            "affiliation": "N",
            "address_1": "1001 Arbor Park Drive",
            "city": "Belton",
            "state": "TX",
            "country_code": "US",
            "postal_code": "76513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.