David T. Carlson, MD

Key facts

NPI

1114985132

Entity type

Individual (NPI type 1)

Primary specialty

Family Medicine Physician 207Q00000X

License

1283 (SD)

Practice address

506 1St Ave SE
Watertown, SD 57201-4402

Phone

(605) 886-8482

Fax

(605) 884-4300

NPI assigned

May 1, 2006

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 19, 2020.

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1114985132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 1ST AVE SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572014402",
            "telephone_number": "605-886-8482",
            "fax_number": "605-884-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 1ST AVE SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572014402",
            "telephone_number": "605-886-8482",
            "fax_number": "605-884-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "DAVID",
        "middle_name": "T.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "1283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5611350",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

• Joni Buechler-Price, M.D.
• Leanne Bunnell, AUDIOLOGIST
• Vickie Lynn Burchatz, COTA
• Jennifer Lee Byer, PA-C
• Care Anywhere
• Amanda Renee Carter-Boomsma, LPC
• Roger L Carter, MD
• Christine Marie Cass, PT
• Catholic Family Services
• Cedar Lakes Therapy, LLC

All providers in Watertown, SD · Family Medicine Physician in South Dakota