Active NPI
Lauren Carlson, R.D, L.D
- Registered Dietitian
- Blaine, MN
National Provider Identifier
1093196321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86021401
- Practice address
- 10961 Club West Pkwy Ste 100
Blaine, MN 55449-5867 - Phone
- (763) 528-2987
- NPI assigned
- Jun 11, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86021401 | MN | Primary |
Addresses
Primary practice location
10961 Club West Pkwy Ste 100
Blaine, MN 55449-5867
Mailing address
11394 Eldorado St NE Unit D
Blaine, MN 55449-4548
Phone (612) 723-6823
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3415 | MN | MD | Professional Counselor |
| 86021401 | MN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433980800000",
"number": "1093196321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11394 ELDORADO ST NE UNIT D",
"city": "BLAINE",
"state": "MN",
"postal_code": "554494548",
"telephone_number": "612-723-6823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10961 CLUB WEST PKWY STE 100",
"city": "BLAINE",
"state": "MN",
"postal_code": "554495867",
"telephone_number": "763-528-2987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "LAUREN",
"name_prefix": "Mrs.",
"credential": "R.D, L.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-11",
"last_updated": "2015-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MN",
"license": "86021401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blaine, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.