Active NPI
Jennifer Lee Carlson, ATC
- Legal Medicine
- Atlanta, GA
National Provider Identifier
1124171061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Legal Medicine
- License
- AT001295
- Practice address
- 4484 Peachtree Rd NE
Atlanta, GA 30319-2737 - Phone
- (404) 364-8486
- NPI assigned
- Jan 22, 2007
- 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 |
|---|---|---|---|---|
| Legal Medicine | 173000000X | AT001295 | GA | Primary |
Addresses
Primary practice location
4484 Peachtree Rd NE
Atlanta, GA 30319-2737
Mailing address
119 Greenfield Way
Newnan, GA 30263
Phone (678) 416-6146
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT001295 | GA | MD | Legal Medicine |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124171061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 GREENFIELD WAY",
"city": "NEWNAN",
"state": "GA",
"postal_code": "30263",
"telephone_number": "678-416-6146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4484 PEACHTREE RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303192737",
"telephone_number": "404-364-8486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "JENNIFER",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "173000000X",
"taxonomy_group": "",
"desc": "Legal Medicine",
"state": "GA",
"license": "AT001295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.