Individual provider Active NPI

Daniel Carlsen, DO

  • Emergency Medicine Physician
  • Marietta, OH
National Provider Identifier
1114554623
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
58.034467 Issued in OH
Practice address
401 Matthew St
Marietta, OH 45750-1635
Phone
(740) 374-1400
NPI assigned
Mar 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN.171600 OH
Emergency Medicine Physician 207P00000X 58.034467 OH Primary

Addresses

Primary practice location

401 Matthew St
Marietta, OH 45750-1635

Mailing address

PO Box 188
Chillicothe, OH 45601-0188
Phone (740) 773-4366

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)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
LPN.171600OHMDLicensed Practical Nurse
58.034467OHMDEmergency Medicine Physician

Interoperability endpoints

  • Direct secure messaging: daniel.carlsen@mmhs.medicity.net

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1114554623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456010188",
            "telephone_number": "740-773-4366",
            "fax_number": "740-775-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MATTHEW ST",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457501635",
            "telephone_number": "740-374-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSEN",
        "first_name": "DANIEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.171600",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "58.034467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.