John Carlsen, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

3495 Issued in TN

Practice address

9125 Cross Park Dr Ste 200
Knoxville, TN 37923-4563

Phone

(865) 632-5900

Fax

(865) 374-2129

NPI assigned

May 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Physician Assistant

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Tennessee Cardiovascular Surgery Group PCGroup PAC ID 6608934203, 20 clinicians

Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173
• Methodist Medical Center of Oak Ridge Hospital, Oak Ridge, TN, CCN 440034
• Fort Sanders Regional Medical Center Hospital, Knoxville, TN, CCN 440125

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: carlsen.john.timothy@covenanthealth.cernerdirect.com

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.

• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010
  Medicare reassignment Care Compare group
• East Tennessee Cardiovascular Surgery Group, P.C

  • Contractor
  • Knoxville, TN
  • NPI 1679525448
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fort Sanders Regional Medical Center

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1942294814
  Care Compare affiliation
• Methodist Medical Center

  • General Acute Care Hospital
  • Oak Ridge, TN
  • NPI 1700870672
  Care Compare affiliation
• Parkwest Medical Center

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1396739165
  Care Compare affiliation

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1114970209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9125 CROSS PARK DR STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234563",
            "telephone_number": "865-632-5900",
            "fax_number": "865-374-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9125 CROSS PARK DR STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234563",
            "telephone_number": "865-632-5900",
            "fax_number": "865-374-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSEN",
        "first_name": "JOHN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "3495",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "001584",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "3495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q047734",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carlsen.john.timothy@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "9125 Cross Park Dr Ste 200",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379234563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joshua Ray Carico, CRNA
• Caring Heart and Hand LLC
• Caris Healthcare
• Christopher Andrew Carle, DDS
• Kristen Anne Carlosh, LPC-MHSP
• Brooke Carlson
• Carl Sanford Carlson Jr., MD
• Edie F Carlson, RN021
• James M Carlson, DO
• Kristen Susan Carlson

• Medical Physician Assistant in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.